- What is the normal protein level in urine during pregnancy?
- How is urine tested for protein?
- What are the types of proteinuria?
- What causes protein in urine when you are pregnant?
- What are the signs of protein in urine during pregnancy?
- Treatment of proteinuria during pregnancy
- How to get rid of protein in urine during pregnancy?
- Frequently asked questions
Urine tests are usually recommended to detect infections or check the level of glucose, blood or pus in it. During pregnancy, the doctors would primarily suggest urine tests to monitor the protein levels and the level of leucocytes in the urine. Medically referred to as proteinuria, high protein in urine suggests dysfunction of the kidney.
What Is The Normal Protein Level In Urine During Pregnancy?
Usually, our urine contains a definite amount of protein. The standard excretion level is usually 300mg/d in normal pregnancy (which is higher than the usual level of 150mg/d in non-pregnant women). This happens as the burden on the kidneys doubles during pregnancy and the increase in blood volume, which adds to the stress on the kidneys.
However, if the levels exceed this value, it could be s sign of a serious disorder (1).
How Is Urine Tested For Protein?
During the regular prenatal checkup, your doctor will ask you for a urine sample. Two types of tests on the sample can help detect proteinuria.
- The dipstick test: A chemically treated strip with patches is inserted into the urine sample. It changes color, revealing the presence of protein in the urine. The level of protein in urine can range from ‘+’ to ‘++++’, with +1 (plus one) being low and +4 (plus four) high (2). High levels of protein indicate preeclampsia or kidney damage, whereas a low level indicates UTI.
- 24-hour urine protein test: It checks the amount of protein spilled into the urine and helps detect specific conditions. Urine samples are collected over a 24-hour period in separate containers and taken for analysis. The first urine (that is in the morning) is not taken into consideration. If the protein levels are higher than 300mg/d in 24 hours, it signals preeclampsia (3).
What Are The Types Of Proteinuria?
There are two types of proteinuria – chronic and onset (4).
- Chronic proteinuria is present before the pregnancy and results from an already existing kidney condition.
- Onset proteinuria develops during pregnancy, which is caused by a condition known as preeclampsia.
What Causes Protein In Urine When You Are Pregnant?
Low levels of protein in the urine are either normal or indicate a minor infection. But high levels indicate serious problems that are detailed below.
- Preeclampsia: This condition is characterized by high blood pressure, protein in urine and fluid retention, which occurs after the 20th week of pregnancy. The other symptoms include headaches, vomiting, blurred vision, and abdominal pain.
When untreated, it could lead to eclampsia (preeclampsia with seizures), kidney disorder, and low birth weight babies (5). On early diagnosis and treatment, you may give birth to a healthy baby. Treatment includes a low salt diet and regular exercise.
- HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count): It usually occurs in women with preeclampsia or eclampsia, but sometimes develops in the absence of these conditions. It shows similar symptoms, along with protein in urine. If not treated on time, it might result in serious complications including low birth weight, stillbirth and preterm labor (5).
- Urinary tract infection (UTI) or kidney infection: If you have the urge to urinate frequently and experience discomfort while urinating, you may have a UTI. It can lead to the appearance of protein in the urine. If this condition is not treated on time, it will lead to a kidney infection that is associated with fever, nausea, vomiting and back pain. Though UTI will not affect the baby, kidney infections could cause low birth weight babies and preterm labor (6).
- Other factors: Some conditions such as emotional stress, dehydration, arthritis, exposure to high temperatures, diabetes, strenuous exercise, and medications also increase the chances of protein in the urine. Certain medical conditions including diabetes, heart disease. rheumatoid arthritis, sickle cell anemia, lupus, and chronic kidney illnesses could also increase the risk, although more research is needed to support this theory.
What Are The Signs Of Protein In Urine During Pregnancy?
In general, proteinuria is mainly detected from the routine urine examinations performed during pregnancy.
A few symptoms that may be experienced with high protein in urine include (7):
- Swelling in the hands, and ankles
- Facial swelling
- Foamy urine
Most importantly, you should be aware of proteinuria in the later part of pregnancy, which could develop from preeclampsia. The symptoms associated with it include (8):
- Blurry or flashy vision
- Swelling of the hands, ankles and face
- Pain underneath the ribs
- A severe headache and vomiting
- Feeling unwell
The above symptoms should prompt you to consult a doctor.
Treatment Of Proteinuria During Pregnancy
Proteinuria is not a disease, but an indication of something abnormal in the body. However, special care has to be taken, and you should not neglect the problem.
Simple dietary and lifestyle changes will help manage the trace levels of protein in urine. But to control high protein levels in the urine, treating the root cause is vital.
- If the underlying cause is diabetes, you require medication, dietary changes, and exercises to control it.
- If it is hypertension, get treatment for managing the condition.
- If preeclampsia is the cause, the treatment depends on the stage of pregnancy.
- If it is UTI or kidney infection, antibiotics can be used.
If the baby has developed enough, the doctor might opt for preterm labor to protect both the mother and the baby (9).
How To Get Rid Of Protein In Urine During Pregnancy?
Simple measures to get rid of proteinuria, mild or severe, include (10):
- Cut down salt intake: Craving sour and salty foods is very common during pregnancy. But increased salt intake will result in higher protein levels in urine. So stay off salty foods, reduces the amount of added salt to your diet and avoid outside food.
- Lower sugar intake: Cakes, desserts, sweets, and ice creams must be removed from your diet. It might significantly reduce the burden on your kidneys, and protects them from infections.
- Manage your weight: Excess weight gain will increase the risk of gestational diabetes or preeclamspsia, which again causes protein discharge in urine. Make an effort to manage your weight by keeping a check on your everyday intake.
- Rest well: Take out some time for yourself from the everyday routine to beat away the stress. It also recharges your body and helps deal with any health conditions better.
- Practice good hygiene: Wipe yourself dry with a clean towel after the shower. Also, wipe front to back after urination. This maintains the gut health and prevents any infections.
- Consume enough water: Hydration is essential to protect yourself from infections. It promotes frequent urination and flushes out kidney and urinary tract infections.
Next, we answer some frequently raised queries from our readers.
Frequently Asked Questions
1. Is albuminuria similar to proteinuria?
Albuminuria is a condition where there is too much albumin protein in the urine. The average amount of albumin is usually less than 20 m/day (11). Albumin protein is usually found in the blood, and healthy kidneys will not filter it into the urine. But a damaged kidney will let some of it flow into the urine. High glucose levels and high blood pressure levels might be the cause of albumin levels in urine (12).
2. What do leucocytes in urine indicate during pregnancy?
Leucocytes are white blood cells that are released in response to foreign particles such as bacteria. Their presence in the urine signals an infection. A high number of these cells in the urine indicate a kidney or bladder infection (13). The urine dipstick also shows positive for leucocytes in case of proteinuria.
3. Why are ketones produced in urine during pregnancy?
The body breaks down fat into ketones, which are found in urine, to produce energy during emergencies such as glucose deficiency or starvation. Trace levels of ketones will not pose a risk, but high levels would indicate gestational diabetes and pose a threat to the fetus (14).
4. Can protein in urine affect a pregnancy test?
Yes, protein in urine may give false positive results because they change the test result. Protein in urine shows positive since pregnancy test detects hCG, which is a protein-based hormone.
If you have a family history of preeclampsia or are at risk of the condition, talk to your doctor about it. Though proteinuria is an indicator of preeclampsia, it might also be asymptomatic sometimes. So never skip a urine test suggested by the doc, as that is the only way to diagnose it.
Have you dealt with proteinuria during pregnancy? Share your experiences or tips on how to manage it in the below comment section.
2. Urinalysis; WebPath Guide – University of Utah
3. 24-Hour Urine Protein; The University of Chicago Medicine (2018)
4. Edited by Ann M. Gronowski; Handbook of Clinical Laboratory Testing During Pregnancy; page 392
5. How do health care providers diagnose preeclampsia, eclampsia, and HELLP syndrome; NIH (2017)
6. Karen J. Carlson et al.; The New Harvard Guide to Women’s Health; page 603
7. Kidneys and Kidney Disease; University of Maryland School of Medicine (2018)
8. Preeclampsia; Beaumont (2018)
9. Lowe SA et al.; The Management of Hypertensive Disorders of Pregnancy; The Society of Obstetric Medicine of Australia and New Zealand (2014)
10. Proteinuria; Kidney & Urology Foundation of America (2018)
11. Albuminuria: Albumin in the Urine; NIH (2016)
12. David K. James ET AL.; High Risk Pregnancy: Management Options (Expert Consult – Online and Print); page 895
13. Blood glucose monitoring and ketone testing; Northwell Health (2018)
14. Albumin (Urine); University of Rochester (2018)