Protein in the urine during pregnancy? May or may not be a problem

A woman's body undergoes many changes during pregnancy. Many things change and some need to be given extra attention. Among these is the appearance of protein in the urine.

This condition is technically called proteinuria. In small amounts, it is usually not a serious problem. This is also the case during pregnancy. However, if values exceed 300 mg, proteinuria can be a sign of serious difficulties or complications in pregnancy.

Proteinuria may be a harbinger that the kidneys cannot handle the increased load caused by pregnancy and are beginning to fail.

The filtration function of the blood is provided by the kidneys. The kidneys excrete all unnecessary and harmful substances from the blood through the urine. When this function is impaired, substances that are necessary for the body may enter the urine along with toxins and other harmful substances. Thus, vital proteins may also leave the body through the urine.

Protein is an essential building block in our bodies. It is part of many processes and the basis for muscles, bones and organs.

Causes that can cause temporary proteinuria:

• Insufficient hydration of the body
• exposure of the body to high temperatures
• fever or hypothermia
• protein diet
• excessive stress
• excessive physical exertion
• taking certain medications, such as penicillin, salicylic acid, certain antibiotics
• kidney cancer
• diabetes
• serious burns
• chemotherapy

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What can proteinuria signal during pregnancy?

A small amount of protein in the urine during pregnancy does not necessarily indicate a problem. It is necessary to be alert if the occurrence is prolonged or if the value exceeds 300 mg. We can distinguish between chronic and acute proteinuria.

Chronic proteinuria

Chronic (longer-term) proteinuria occurs before the 20th week of pregnancy. It usually occurs as a result of pre-existing kidney disease. The solution is early diagnosis, detection of the cause of proteinuria and treatment of the disease that caused it.

Acute proteinuria

It occurs in the context of pregnancy. The most serious triggering cause is a disease called pre-eclampsia. In terms of the severity of this disease, this possibility should be ruled out first.

The origin of pre-eclampsia has not yet been fully elucidated. It is essentially a disease of the placenta, where the fetus is not nourished sufficiently from the mother's blood vessels. The body's response is to increase blood pressure in order to provide more blood with nutrients and oxygen for the fetus.

However, the substances that cause the increased pressure are also responsible for damage to blood vessels and some organs. Typical symptoms of pre-eclampsia are swelling, high blood pressure and the appearance of protein in the urine.

Pre-eclampsia poses a risk to both the mother and the unborn baby.

Symptoms of pre-eclampsia include:

• Headaches
• nausea
• vomiting
• abdominal pain
• urinary disorders
• blurred vision

Protein in the urine is also found in conditions called eclampsia and HELLP syndrome. Eclampsia is the culmination of pre-eclampsia. In it, convulsive seizures occur before, during or after delivery. The condition requires immediate management.

HELLP syndrome is a severe form of pre-eclampsia. Red blood cells break down, liver enzymes are elevated and platelet count is reduced.

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Other causes of protein in the urine during pregnancy

During pregnancy, a woman's body adapts to many changes. For example, a different posture and forward curvature of the lumbar spine can contribute to the excretion of protein in the urine. Also, the pressure of the uterus on the kidneys and bladder. Last but not least, there are also increased demands on the functions of the urinary system.

A common cause of proteinuria can be a urinary tract infection. It can manifest itself by frequent urges to urinate, urinating small amounts of urine and cutting or burning when urinating. Increased temperature, lower abdominal pain, nausea and vomiting can also be associated.

To prevent further spread of the infection into the body and the complications that inflammation can cause, your doctor must prescribe antibiotics. However, these must be appropriate and harmless during pregnancy.

Other causes of proteinuria can be:

• Stress
• Increased temperature, fever
• Dehydration
• excessive physical exertion
• diabetes mellitus

Proteinuria may be long-lasting, but may also be transient. Similarly, kidney function may or may not be impaired.

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Do you suspect the presence of protein in the urine?

During pregnancy, your urine is checked regularly at your gynecological outpatient clinic. It is part of the care of a pregnant woman. However, if you have any doubts, do not hesitate to contact your gynecologist.

Possible symptoms of proteinuria:

• joint and bone pain
• weakness and sleep disturbances
• swelling
• increased blood pressure
• cloudy urine
• muscle pain

In the outpatient clinic, a check is carried out using a special paper stick that is dipped into a urine sample. Indicators on the stick change colour to show not only the possible presence of protein, but also sugar.

To avoid biased results, a sterile container should be used to collect the urine. The ideal is to take a sample of the first urine of the morning and capture the so-called midstream. This means capturing the urine after about three seconds of urination.

A more accurate test is the so-called 24-hour urine analysis. This is collected for 24 hours in a designated collection container. A sample is then examined.

In the table below we list some of the causes that change the colour of urine

How to proceed when proteinuria is detected during pregnancy

In connection with the value of protein in the urine, the doctor will order further collections and necessary examinations. Depending on the condition, hospitalization is even possible to monitor the condition.

It is necessary to find out the cause of proteinuria. On the basis of it, the appropriate treatment or solution of the condition is determined. It can be diabetes, inflammation of the kidneys, but also a serious condition such as preeclampsia.

Appropriate diet in the presence of protein in the urine

As far as diet is concerned, it is advisable to limit the intake of salt, sugar and alcohol. Spicy and spicy foods should also be avoided. A sufficient drinking regime is also necessary.

A full and balanced diet will help the kidneys to function properly.

Recommended foods for proteinuria:

• Fruit and vegetables
• Cereals
• pumpkin
• cottage cheese
• raisins
• dried apricots
• blackcurrant drinks

Try to avoid or limit your intake of these foods:

• meat and fish
• eggs
• raw milk
• salty, fried and smoked foods

Prevention and risks in pregnancy

As part of prevention, it is advisable to check blood pressure regularly. There are also special exercises to improve blood circulation and promote proper kidney function in pregnancy.

The risk of kidney disease, pre-eclampsia and other disorders increases as the age of the mother increases. This may be an aggravation of an existing disease, but also a newly developed disorder.

The approach to such patients requires care not only in gynaecology and nephrology. The condition often extends beyond these areas and synergy from cardiovascular or other areas is also required.