Overview
To check for protein in urine during pregnancy, you will be requested to pee in a cup at each of your prenatal visits.
Your urine is an improtant indicator of your health. While it is considered normal to have some amount of protein in your urine even during pregnancy, occasionally elevated protein levels in your urine can reflect a serious issue. A single urine sample can help determine if you have an infection, diabetes, or are simply dehydrated. High protein in urine during pregnancy may be a sign of anything, including stress, fever or preeclampsia.
Preeclampsia carries serious risks for the mother and the baby. Hence, it is essential to know what it means when you have protein in urine when pregnant and how these conditions related to high protein in pregnancy are treated. This article helps cover all of that.
What causes protein in urine during pregnancy?
Trace protein in urine during pregnancy may be expected as kidneys work hard to filter the waste products in your blood. The average protein in urine during pregnancy is less than 300mg/day. Protein usually is not a component of urine. Besides pregnancy, several conditions can cause an elevation of protein in the urine temporarily:
- emotional or physical stress
- fever
- dehydration
- exposure to extreme temperatures
Proteinuria during pregnancy may be a sign of something more sinister. Protein in urine before 20 weeks of pregnancy, often referred to as chronic proteinuria, is usually due to a preexisting health condition or an underlying disease such as kidney disease, heart disease, urinary tract infection, etc. These conditions elevate the protein levels in your urine and hence require medical attention.
On the other hand, proteinuria in pregnancy, after 20 weeks, needs to be monitored more closely as it may be an indicator of preeclampsia. This hallmark symptom is high blood pressure, which leads to organ damage, specifically to the kidneys and the liver.
HELLP syndrome (hemolysis, deranged/elevated liver enzymes, and reduced platelet count) is a more severe form of preeclampsia that can develop alongside preeclampsia or on its own as well. If untreated, both conditions can be a threat to the mother and baby.
According to Dr. Wetter, certain conditions may cause your kidneys to be strained and increase protein levels in urine while pregnant, namely hypertension, diabetes, lupus, or kidney disease.
What are the signs of protein in urine during pregnancy?
A reading greater than 300 mg/d of protein in your urine is considered high. Although, you may or may not even exhibit any symptoms of protein in your urine. It may be an incidental finding on the next prenatal appointment when you get your urine tested.
Symptoms experienced may be similar to those of kidney disease:
- burning sensation while urinating
- increased urination
- foamy or brown/bloody urine
- swelling in the ankles, wrists, or eyes
- back pain
Additional signs and symptoms that indicate preeclampsia include:
- Severe headaches
- Shortness of breath
- Nausea/vomiting
- Blurry vision or other vision issues
- Pain in your abdomen
- Reduced urine output
Gaining weight during pregnancy is expected but a drastic weight gain may be due to proteinuria in pregnancy. Excessive weight gain and swelling in the hands or face are some other warning signs that must be monitored to rule out high protein in pregnancy.
How is proteinuria diagnosed in pregnancy?
What makes the diagnosis challenging is that symptoms of proteinuria, such as back pain and an increased urgency, commonly occur in healthy pregnancies as well. A simple home test for protein in urine can help differentiate if the current symptoms are a part of pregnancy or due to another medical condition. Moreover, an at-home urine protein test strip or urine dipstick test can help detect protein in your urine and can be used to monitor for protein in your urine. This will aid in early diagnosis and prompt treatment. If your results are positive for protein, 24-hour protein urine pregnancy and further testing are required.
Other tests, especially if preeclampsia is suspected, include:
- Blood tests which check your liver function kidney function, and identify your platelet count.
- Ultrasound helps check the amount of amniotic fluid and monitor your baby’s development.
- Biophysical profiles to determine your baby’s health status.
How can I reduce protein in my urine during pregnancy?
In case of preexisting conditions, It’s always a good idea to practice caution before becoming pregnant. Maintaining a healthy weight, consuming a balanced diet containing plenty of lean protein and vegetables, and managing blood pressure are all essential components.
However, if you’re already pregnant, the following measures help lower your risk of developing preeclampsia:
- Taking low-dose aspirin: For those with a history of preeclampsia, multiple pregnancies, chronic high blood pressure, kidney disease or diabetes, this may prove to be beneficial. The recommended dosage is 81 milligrams, started at week 12 in pregnancy. This is best done under a doctor’s supervision.
- Taking calcium supplements: Taking supplements may also prevent preeclampsia in case of a calcium deficiency.
What are the risk factors for proteinuria in pregnancy?
The risks and outcomes of having protein in urine during pregnancy are directly dependent on the cause. Some causes may be less severe and easier to treat as compared to others. Nonetheless, an evaluation is a must.
Generally speaking, most causes of protein in urine in early pregnancy are not associated with serious risks. “If protein is found in your urine before 20 weeks, it is less likely to be a concerning symptom,” says Maggie Bolton, CNM, ARNP, clinical director of Quilted Health.
However, high protein in the urine after 20 weeks can have detrimental effects on you or your baby. Moreover, if your blood pressure is high and you are experiencing blurred vision, swelling, and shortness of breath, that is a defined case of preeclampsia, which will require monitoring and treatment.
Preeclampsia can get worse and can affect many body systems. Untreated cases increase the risk of the following:
- HELLP syndrome & damage to vital organs
- Increased risk of placental abruption(detachment of the placenta from the wall of the uterus)
- Compromised blood flow to the placenta (which can eventually lead to pre-term birth and respiratory problems)
- Cardiovascular problems(in the future)
- Death
What does protein in urine look like?
Bubbles in urine during pregnancy or foamy urine may be the only sign indicating an infection or protein in the urine.
The following symptoms, although unspecific, may indicate the presence of protein in the urine:
- foamy urine
- frequent urination
- muscle cramps at night
- swelling in the hands, feet, face, or abdomen
- nausea
- vomiting
Who is at high risk for preeclampsia?
The following are some factors that can increase a woman’s risk for developing preeclampsia:
- Hypertension and kidney disease before pregnancy
- Preeclampsia in an earlier pregnancy
- Family history of preeclampsia
- Obesity
- Age younger than 25 years old or older than 35 years old
- Multiple gestations
- African American ethnicity
- Preeclampsia is also more common in those who have certain health conditions, such as migraines, diabetes, polycystic ovary syndrome, urinary tract infections, gum disease, rheumatoid arthritis, multiple sclerosis, lupus, scleroderma, gestational diabetes, and sickle cell disease.
- Preeclampsia is also a more common occurrence in pregnancies than due to in vitro fertilization.
How is protein in the urine treated during pregnancy?
Some amount or trace amounts of protein in the urine may not raise a red flag, but monitoring is definitely required. The treatment is also dependent on the cause.
During early pregnancy, high protein in urine is usually due to underlying chronic health conditions, and hence, the treatment plan will address the safety of both you and your baby.
If urinary tract infections are causing the symptoms, they can be safely cured with antibiotics. For other complications, you may need more monitoring by a specialist.
However, after 20 weeks, protein in urine during the third trimester can be concerning and indicate preeclampsia. The treatment plan will depend on how far along you are, the severity of your condition, and the baby’s condition. The most effective treatment for preeclampsia is prompt delivery, but that depends on how far along you are.
Other treatment options include:
- Blood pressure medications: Safe antihypertensives are used to lower blood pressure when it’s elevated.
- Frequent monitoring: Regular monitoring of the mother and baby is carried out regularly.
- Bed rest. Initially, doctors used to advise bed rest to those with preeclampsia. However, there is a mixed opinion on this, as bed rest may increase the risk of blood clots.
In cases of severe preeclampsia, the only choice left is delivery. If early delivery is required, you will most likely be given 1 or 2 injections of corticosteroids to aid in maturing your baby’s lungs.
If you develop HELLP syndrome, you will need to take corticosteroids to help normalize your liver and platelet function. This can help prolong your pregnancy and help your baby develop. If untreated, preeclampsia can lead to severe bleeding, placental abruption, stroke, or seizures. If not dealt with properly, preeclampsia can be fatal.
Consult a doctor
It is vital to discuss any changes or out-of-the-blue symptoms that you notice throughout your pregnancy with your physician. Many conditions can be treated and prevented with early diagnosis. After reading this article, you must have realized the significance of protein in your urine during pregnancy; talk to our doctor at Your Doctors Online for any questions you may have!
FAQs about protein in urine during pregnancy
A slight increase up to 300mg/d is considered normal and a part of physiological changes during pregnancy. However, higher levels than that, especially after 20 weeks of pregnancy, are concerning.
Preeclampsia has the tendency to develop gradually or abruptly. There is a possibility that signs and symptoms go undetected for weeks or months, but the progression is sudden.
Some other conditions that may be confused with preeclampsia include liver disorders, hypertension, alcoholism, hyperthyroidism, myocardial Infarction, etc.
Urinary protein exceeding 300 mg/24 hours a day is considered abnormal in pregnant women.
The following food sources tend to increase protein in the body/urine:
1. Red meat: Beef, pork, and lamb.
2. Processed foods: Sausages and deli meats.
3. Dairy products: Milk and cheese etc
4. Eggs
5. Soy products: Soy milk and Tofu.
