Indicators of general urine analysis in pregnant women. Types of urine tests and collection rules
A general urine test during pregnancy is one of the main types of laboratory diagnostics. This study includes determination physical properties And chemical composition urine, as well as sediment microscopy, which makes it possible to identify pathologies urinary tract, as well as violations from other organs and systems.
Urine, or urine, is a waste product of the body that is excreted by the kidneys. Urine is an aqueous solution of electrolytes and organic substances. Water makes up 92–99% of the total volume of urine. Every day, 50–70 substances (mainly urea and sodium chloride) are excreted from the human body in urine.
Deviations from the norm in a general urine test in the 2nd and 3rd trimester of pregnancy are often not signs of disease, but are caused by increased pressure on the kidneys of the growing uterus.
During pregnancy, a woman's urinary system undergoes certain changes: the size of the kidneys increases by about 2 cm, the ureters dilate, and renal blood flow increases. The urinary system in pregnant women in general and the kidneys in particular are subject to increased stress, as they remove waste products from not one, but two organisms. In addition, the body of a pregnant woman is more vulnerable to infections of the genitourinary system due to a slight decrease in immunity. Regular general analysis urine allows you to timely identify deviations, eliminate them and thereby prevent the development of adverse consequences, which may include miscarriage and premature birth.
A general urine test during pregnancy is carried out regularly from the moment of registration until birth. The frequency depends on the condition of the pregnant woman, the presence of any diseases or abnormalities in the course of pregnancy. Typically, the study is carried out once a month, if indicated - 2 times a month or more often. An extraordinary urine test is required if microorganisms, glucose, ketone bodies, protein, as well as upon receipt cloudy urine mixed with blood. If your urine is reddish, brown, dark yellow, or unusual in color, bad smell, this also requires extraordinary research.
Preparation and delivery of urine analysis
For getting reliable results You need to prepare for a general urine test. If this is not done, the results may be distorted. For example, the sample may contain protein and bacteria that have entered the urine with secretions from genitourinary tract, which can be mistakenly taken for signs of an infectious process.
Red blood cells in the urine of a pregnant woman can appear when the growing fetus strongly compresses the bladder and ureters, rapid changes hormonal levels.
Preparation for the analysis begins one day before the study and consists of the following:
- stop taking medicines(must be discussed with the doctor prescribing the referral for analysis);
- exclude from the diet spicy and fatty foods, alcohol, as well as foods that can color urine (beets, carrots, blueberries, vitamin complexes etc.);
- exclude sexual contacts.
Stick to any special diet And drinking regime not necessary (except as specified).
Immediately before collecting urine, the external genitalia should be toileted. For research, the first morning urine is collected, with the initial portion flushed down the toilet, the rest of the urine is collected in a clean, dry container, which is issued in the laboratory or purchased at the pharmacy. For a general urine test, at least 70 ml must be collected. The container should be delivered to the laboratory within 1–2 hours, otherwise the test results may be distorted.
Urinalysis: normal values
A pH level below normal may indicate potassium deficiency in the body, dehydration or kidney pathology, diabetes mellitus, metabolic and respiratory acidosis, fever, fasting, or following a low-carbohydrate diet.
Specific gravity
The specific gravity (density) of urine is an indicator that allows you to identify hidden pathological processes. The specific gravity depends on the content of glucose, protein, salts and other compounds in the urine. A change in this indicator can have both physiological (amount of fluid consumed) and pathological (diabetes mellitus, chronic renal failure, diuretic therapy) reasons.
The appearance of protein in a pregnant woman's urine test, especially in combination with high blood pressure and swelling, most likely indicates the development of gestosis.
The specific gravity increases in the presence of glucose, protein in the urine, as well as a small amount of excreted urine due to an increase in its concentration. A decrease in density occurs with kidney disorders, hormonal imbalance, large amounts of urine excreted, etc.
Protein
Finding protein in urine may indicate fever, stress, inflammatory diseases urinary system, pyelo- or glomerulonephritis, nephrotic syndrome, nephrosclerosis, diabetic nephropathy, heart failure, malignant neoplasms urinary tract, multiple myeloma, sarcoidosis, sickle cell anemia, intoxication with heavy metal salts.
The appearance of protein in a pregnant woman’s urine test, especially in combination with high blood pressure and swelling, most likely indicates the development of preeclampsia.
Glucose
In the 2nd trimester of pregnancy, physiological glucosuria (glucose in the urine) is often observed, which does not require treatment. However, repeated detection of glucose in the urine may indicate the development of diabetes in pregnant women (gestational diabetes), which can lead to the development of complications, and after childbirth it can develop into true diabetes mellitus. In addition, glucose in urine can be determined in tubulointerstitial kidney diseases, myocardial infarction, hyperthyroidism, acute pancreatitis, extensive injuries and/or burns, consumption of large quantity carbohydrates.
Ketone bodies
Ketone bodies are found in the urine in cases of decompensated diabetes mellitus, hyperglycemic coma, glycogenosis, hypercatecholaminemia, severe fever, eclampsia, prolonged fasting, lack of carbohydrates in the diet, and alcohol abuse. The presence of ketone bodies in urine may indicate pathologies of the liver, stomach, and pancreas.
An extraordinary urine test is required if microorganisms, glucose, ketone bodies, protein are detected in the urine of a pregnant woman, as well as if cloudy urine mixed with blood is obtained.
Bilirubin and urobilinogen
Bilirubin appears in the urine in viral hepatitis, liver cirrhosis, obstructive jaundice, and secondary liver tumors.
An increase in the level of urobilinogen in the urine occurs after intense physical exercise, with hemolytic or pernicious anemia, myocardial infarction, heart failure, resorption of massive hematomas, intravascular hemolysis, liver pathologies ( viral hepatitis, toxic damage, failure, neoplasms, etc.). In addition, urobilinogen is present in urine in case of its increased formation in digestive tract for intestinal obstruction, ileitis, enterocolitis, infections of the biliary system.
Hemoglobin and red blood cells
Hemoglobin is found in urine in cases of hemolytic anemia, sepsis, extensive burns, poisoning with mushrooms, phenol, and aniline.
Red blood cells in the urine of a pregnant woman can appear due to strong compression of the growing fetus on the bladder and ureters, rapid changes in hormonal levels. In addition, red blood cells in the urine are detected in cases of pyelonephritis, glomerulonephritis, urolithiasis, urinary tract infections, kidney injuries, increased blood pressure, hemorrhagic diathesis, systemic lupus erythematosus, etc.
Leukocytes
The number of leukocytes in the urine increases with pyelonephritis and other infectious and inflammatory diseases of the urinary tract, glomerulonephritis, urolithiasis, tubulointerstitial nephritis, kidney transplant rejection, systemic diseases.
Cylinders
Cylinders are peculiar casts of the renal tubules, consisting of cell remains, inflammatory infiltrate and other layers that appear in the urine under pathological conditions.
For a general urine test, at least 70 ml must be collected. The container should be delivered to the laboratory within 1–2 hours, otherwise the test results may be distorted.
Depending on which cylinders are found in the urine, one or another pathology can be assumed:
- hyaline– consist predominantly of protein; appear in the urine with pyelonephritis, glomerulonephritis, urolithiasis, neoplasms, kidney tuberculosis, heart failure, high blood pressure, fever, intense physical activity, taking diuretics;
- grainy– consist of protein and renal epithelium; found in urine in cases of pyelo- or glomerulonephritis, diabetic nephropathy, infectious diseases viral etiology, fever, lead poisoning;
- leukocyte– consist of protein and leukocytes; found in pyelonephritis, systemic diseases (for example, systemic lupus erythematosus);
- erythrocyte– consist of red blood cells: may indicate the presence of hypertension, acute form of glomerulonephritis, renal vein thrombosis, renal infarction;
- epithelial– from the renal epithelium; appear in urine when viral infections, amyloidosis, acute renal tubular necrosis, kidney transplant rejection, poisoning with heavy metal salts;
- waxy– consist of hyaline and granular cylinders, formed against the background of stagnation of urine; found in chronic renal failure, nephrotic syndrome, renal amyloidosis.
Epithelium
Renal epithelium is found in the urine during pyelonephritis, nephrosclerosis, taking a number of medications (salicylates, bismuth preparations), and poisoning with heavy metal salts.
The presence of a large number of other types of epithelium may indicate inflammatory process in the urinary tract.
The urinary system in pregnant women in general and the kidneys in particular are subject to increased stress, as they remove waste products from not one, but two organisms.
Salts
The appearance of salts in the urine, as a rule, is a sign of metabolic disorders or dietary errors:
- oxalates– for pyelonephritis, diabetes mellitus, as well as when eating asparagus, spinach, rhubarb, tomatoes;
- urates– with physical activity, fever, gout, renal failure, dehydration, as well as eating large amounts of protein foods;
- tripelphosphates– for infections of the upper urinary system, hyperparathyroidism, following a predominantly dairy-vegetable diet, after vomiting.
Mucus and bacteria
The amount of mucus in the urine increases with infectious processes of the urinary tract. Also, bacteria are usually found in the urine.
Deviations in urine test results during pregnancy: causes, correction
Deviations from the norm in a general urine test in the 2nd and 3rd trimester of pregnancy are often not signs of disease, but are caused by increased pressure on the kidneys of the growing uterus, are a consequence of dietary habits, physical or emotional stress, as well as non-compliance with the rules for collecting material for research. Therefore, if a result is obtained that is outside the normal range, the analysis is repeated. In some cases, additional urine tests are prescribed (urinalysis according to Nechiporenko, according to Zimnitsky, bacteriological urine culture, etc.), blood and other studies.
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The end products of metabolism, excess water, salts, some hormones, enzymes and vitamins are removed from the body with urine. A general urine test allows us to get an idea of the condition of not only the kidneys, but also other organs: the heart, liver, and gastrointestinal tract.
Information During pregnancy, a general urine test is taken upon registration and then before each visit to the doctor.
The result of the study largely depends on the correctness of the conditions for urine collection:
- The day before the test, do not consume any coloring foods (beets, carrots);
- Stop taking diuretics and other medications (in consultation with your doctor) also one day before the test;
- It is advisable to avoid heavy physical activity the day before the test - this may affect the concentration of protein in the urine;
- Immediately before collecting urine, it is necessary to thoroughly clean the external genitalia, wash the jar well and dry it. The study requires an average portion of urine, a volume of more than 70 ml for more precise definition density;
- Keep collected urine no more than 1.5 – 2 hours possible.
Urine test interpretation
Physical properties of urine:
Quantity morning urine is usually 150 - 250 ml and does not give an idea of daily diuresis. Measuring the quantity is necessary to determine the density of urine.
Color depends on the volume of urine excreted and the amount coloring pigments. Normal urine color is straw-yellow, due to the presence of the urinary pigment urochrome.
Transparency urine reflects the properties of the substances it contains. Normally, all substances are in solution, so fresh urine is absolutely transparent.
Density ( specific gravity) depends on the concentration of substances dissolved in the urine (protein, glucose, urea, salts).
Chemical examination of urine:
Acidity of urinePh determined by the concentration of hydrogen ions H +, which are formed during the dissociation of organic acids and acid salts of inorganic acids contained in urine.
A healthy woman is practically not defined. This is due to tubular reabsorption of protein filtered in the glomeruli. The detection of protein in the urine is called proteinuria. It can be physiological and pathological. In uncomplicated pregnancy, orthostatic proteinuria (protein concentration in urine up to 0.033 g/l) can sometimes be detected. The cause may be compression of the inferior vena cava by the liver and the uterus of the renal veins. Physiological proteinuria also includes the appearance of protein in the urine after taking a large amount of protein food, after a strong physical activity, emotional stress.
Glucose, caught in primary urine is also completely reabsorbed in the renal tubules, and standard methods it cannot be detected. Glucose is detected in the urine when its concentration in the blood increases above the renal threshold - 8.8 - 9.9 mmol/l or when the renal threshold decreases (diabetes mellitus).
important Physiological short-term glucosuria can also occur in healthy people with a large amount of carbohydrates in the daily diet, with. Glucosuria during normal pregnancy is associated with an increase in glomerular filtration of glucose.
Bilirubin It is not detected in the urine of healthy people, because only direct bilirubin, the content of which in the blood is insignificant, can pass through the glomerular filter. And there is a very small amount of it in the urine, which quality samples not detected.
Urobilinogen is formed from bilirubin in the intestine, which comes with bile from the liver. Normally, traces of urobilinogen are found in the urine. Their complete absence indicates a violation of the flow of bile into the intestines.
Ketone bodies are absent normally and appear with an increase in their concentration in the blood.
Microscopic examination of urine sediment:
There are organized (erythrocytes, leukocytes, epithelium and cylinders) and unorganized sediment (various salts).
Red blood cells in the urine of healthy people are absent or rare. They do not pass through the glomerular filter and appear in urine when pathological processes in the kidneys and/or urinary tract.
Leukocytes absent or single in the field of view. (more than 5 leukocytes per field of view) can be aseptic and infectious.
Epithelial cells there may be single ones in the field of view, heard from different parts of the urinary tract: flat (urethra), transitional (pelvis, ureter bladder). Renal (tubular) epithelium is normally absent. By increasing a certain type of cell, the localization of the pathological process is determined.
Cylinders – these are casts of renal tubules of cellular or protein composition. Hyaline casts, composed of protein, may be present normally after exercise. Cell casts always indicate the presence of pathology.
Bacteria normally absent, but bacteriuria does not always indicate an inflammatory process; the number of bacteria is of primary importance.
Salt. The appearance of crystals of various salts in the urine indicates a change in the urine reaction. Normal in a small amount only oxalates and amorphous urates may be present.
Normal indicators of general clinical urine analysis in pregnant women:
| Index | Characteristic or meaning |
| Quantity | 150 – 200 ml |
| Color | Straw to amber yellow |
| Transparency | Full |
| Density | 1.010 – 1.030 |
| PH | 5.0 – 7.0 |
| Protein | Up to 0.033 g/l |
| Glucose | Absent |
| Bilirubin | Absent |
| Urobilinogen | Footprints |
| Ketone bodies | None |
| Red blood cells | 1 – 2 in field of view |
| Leukocytes | Up to 5 in sight |
| Epithelium | Single cells of transitional and squamous epithelium in the field of view |
| Cylinders | Single hyaline casts in the field of view |
| Salts | Single amorphous urates and oxalates |
Additionally If there are changes in the urine test, a repeat test is first ordered to confirm, and then additional methods examinations.
Additional tests (if indicated)
Urinalysis according to Nechiporenko allows you to study the cellular composition of urine in more detail. This study is prescribed:
- with changes in the general urine analysis (appearance of a large number of red blood cells, leukocytes, casts),
- If you have symptoms of kidney disease,
- As a treatment control.
Table: normal indicators:
Most common reasons increase in indicators:
Red blood cells:
- Urolithiasis disease;
- Glomerulonephritis;
- Polycystic kidney disease;
- Complicated pyelonephritis;
- Urinary tract infection;
- Malignant hypertension;
- Systemic diseases (systemic lupus erythematosus, vasculitis, collagenosis).
Leukocytes:
- Cystitis;
- Glomerulonephritis;
- Fever of any origin.
Cylinders:
- Preeclampsia, Eclampsia;
- Acute renal failure;
- Glomerulonephritis;
- Pyelonephritis;
- Nephropathy of pregnancy;
- Intense physical activity.
Urine analysis according to Zimnitsky allows you to assess the concentration ability of the kidneys. The study is prescribed for kidney diseases, systemic diseases, complications of pregnancy (severe toxicosis, gestosis, nephropathy).
To do this, you need to collect urine every three hours in different containers. Three hours before the start of collection, you must completely empty your bladder. You also need to record the amount of all liquid consumed. The study evaluates:
- The amount of urine and its density in each portion. Normally, the change in volume can range from 40 to 350 ml. The difference between the maximum and minimum density indicators must be at least 0.012 – 0.015 (for example, 0.015 – 0.028);
- The total amount of urine excreted per day is normally 70–80% of the fluid consumed;
- The ratio of daytime and nighttime diuresis. The amount of daily urine averages 60–70% of the daily volume.
Determination of daily diuresis gives an idea of the fluid consumed and excreted from the body. A simpler and more economical method compared to the Zimnitsky analysis, when you simply need to determine whether fluid is accumulating in the body. You just need to measure the amount of all urine per day and write it down along with the amount of liquid you drink and the vegetables, fruits and liquid portion of soups consumed. Water balance Normally it is 70-80%. Analysis is prescribed when edema occurs in pregnant women and in the treatment of preeclampsia.
Urine analysis for glucosuric profile carried out when glucose is detected in a general urine test and if there is diabetes mellitus. For the study, daily urine is collected in three jars: from 8:00 to 14:00 you need to urinate in the first jar, from 14:00 to 22:00 in the second and from 22:00 to 8:00 in the third. Determined total excreted glucose per day.
Bacteriological culture of urine (bacteriological culture) carried out to identify and identify pathogens of diseases of the urinary system, as well as determine their sensitivity to antibiotics. To do this, urine is placed on a nutrient medium (agar, sugar broth) and the growth of microorganisms is observed. Indications:
- Urinary tract infections;
- Monitoring the treatment;
- Asymptomatic bacteriuria in pregnant women;
- Diabetes;
- Immunodeficiency;
- Suspicion of antibiotic-resistant flora.
For the study, an average portion of morning urine (3–5 ml) is taken, collected in a sterile container.
Physiological changes in the urinary system during pregnancy
During pregnancy, a woman’s kidneys work in an intensive mode, removing from the body not only the products of their metabolism, but also the products of the fetus’s metabolism. That is why frequent and careful monitoring of changes in the quality, quantity of urine and its cellular composition is necessary.
In the first trimester of pregnancy, there is an increase in renal blood flow and gradual decrease in the future, which makes it possible for other organs to receive additional volume blood. Glomerular filtration increases, and tubular reabsorption does not change throughout pregnancy, this contributes to fluid retention in the body, which manifests itself as pastyness on the legs at the end of pregnancy.
As the uterus grows, the location of adjacent organs changes. Towards the end of pregnancy, the bladder moves upward beyond the boundaries of the small pelvis, its walls hypertrophy to resist compression by the uterus. Sometimes the development of hydroureter can be observed (impaired patency of the ureter and, as a result, accumulation of urine in it), which occurs more often on the right. The reason is that the pregnant uterus turns slightly to the right, pressing the ureter against the innominate line of the pelvic bone.
Under the influence of hormones (in to a greater extent progesterone) there is an expansion and decrease in tone urinary tract, which contributes to the development of infection during pregnancy (pyelonephritis).
A general urine test during pregnancy is one of the main and frequently performed tests. This is primarily due to the fact that the fetus growing in the uterus begins to put pressure on all nearby organs.
The kidneys are one of the first to respond to such changes in the female body. Often there is a malfunction in their work: kidney failure and diseases of the genitourinary system occur. For timely diagnosis of the onset of the disease, the gynecologist prescribes a general urine test every two weeks. In fact, it turns out for each subsequent appointment, depending on the stage of pregnancy.
- 1st trimester - once a month;
- 2nd trimester - once every two weeks;
- 3rd trimester, starting from 34-35 weeks, the study is carried out weekly.
This laboratory diagnostics contributes to the timely detection of disorders of the genitourinary system that affect normal development future baby. Prevents exacerbation chronic diseases due to weakened immunity during pregnancy.
It is OAM that is able to identify signs of gestosis, which causes significant damage to the health of the expectant mother and baby.
Rules for collecting urine for clinical analysis
The objectivity of the results of a general urine test directly depends on the pregnant woman’s compliance with certain rules:
- The laboratory includes an average urine sample collected in the morning immediately after sleep.
- The container for the tank material must be sterile with a tight-fitting plastic lid.
- The container with the material must be delivered to the laboratory within two hours from the moment of collection. This is the only way to preserve the original properties of urine and avoid the penetration of bacteria into it. In this case, the result will be as reliable as possible. Don’t forget to write your name large and clearly on the jar, or attach a referral from your doctor.
Preparation for OAM
- Complete exclusion of all medications. Prenatal vitamins also fall into this category. There is nothing wrong with missing one day of treatment.
- The day before, try not to eat foods containing natural dyes- beets, carrots, blueberries, cranberries.
- Avoid sexual intercourse completely, or doctors allow a pause of 12 hours.
Collection of biomaterial
- It is necessary to carry out careful hygiene of the genital organs.
- Insert a tampon or cover the vaginal opening cotton pad. This will prevent vaginal discharge from getting into the test material.
- Avoid touching the container with body parts as much as possible.
- Make it a rule to collect only the middle portion of urine. To carry out the examination, 50 ml of biomaterial will be sufficient. IN in rare cases the laboratory technician may request up to 250 ml of urine.
Absolutely every woman preparing for the birth of a child should know how to correctly take a general urine test while pregnant.
There are often cases when violation of norms leads to unreliably disastrous results and makes the expectant mother quite nervous.
Results and their implications
A transcript of the results of a clinical urine test is ready the next day after the biomaterial is submitted.
A urine test in a pregnant woman involves several aspects:
- determination of physical and chemical properties;
- biochemistry;
- microscopic examination of sediment;
Characteristics of the components of the analysis
The table contains the main indicators that doctors pay attention to when managing pregnancy.
| Index | Norm | Reasons for deviations |
| Density | from 1010 to 1030 g/l | Glomerulonephritis, diabetes mellitus, and insufficient fluid intake are diagnosed with increased density. A reduced level of density indicates chronic renal failure. |
| Color, transparency | Straw yellow color transparent |
Urolithiasis disease Cystitis, gallbladder pathology Bright – Orange color- a consequence of a pregnant woman taking vitamins before taking the test. |
| Acidity | From 5 to 8 | The indicator is reduced in renal failure, diabetes mellitus, and tuberculosis of the urinary organs. |
| Protein | Absent or no more than 0.033 g/l | Proteinuria, indicating gestosis. |
| Glucose | Absent or not more than 0.083 g/l | Gestational diabetes mellitus, effects of stress In the second trimester, detection of sugar is allowed due to the processes occurring in female body in connection with pregnancy. |
| Bilirubin | Absent | Obstructive jaundice, viral hepatitis. Sign increased bilirubin is dark color urine. |
| Ketone bodies | None | Toxicosis, anemia, diabetes mellitus |
| Urobilinogen | Traces are allowed | At complete absence traces suggest cholestasis or gallstone disease |
| Red blood cells | Absent or sporadic | Pathology of the urinary system |
| Leukocytes | 5 or less within sight | Inflammation of the urinary organs An increased indicator is a sign of poor personal hygiene, penetration of secretions from the genital organs into the biomaterial. |
| Epithelium | No more than 3 | Increased indicator – cystitis, urethritis. Increased epithelial cells – pyelonephritis, urolithiasis of the kidneys. |
| Cylinders | none | The presence of epithelial casts indicates kidney inflammation |
| Fungi, bacteria | none | Presence of fungal traces – possible sign pyelonephritis or disorders elementary rules hygiene. |
| Salts | No uric acid crystals | Early toxicosis, poor diet, inflammation of the genitourinary system. |
| Slime | In moderation | In the absence of other signs of disease, the presence of mucus indicates poor personal hygiene. |
While awaiting the results of the study, it is important to remember that their interpretation is the work of a highly qualified professional. It is impossible to make an accurate diagnosis based on one indicator alone. This must be a set of signs. But even in this case, the doctor will have to send the pregnant patient for a more thorough diagnosis. As a rule, this is a repeated OAM, a urine test according to Nechiporenko, and a blood test.
Actions if indicators deviate from the norm
A poor test result is an indicator to retake the test in order to exclude an incorrect diagnosis. However, if deviations from the norm remain, the doctor is obliged to prescribe treatment.
Increased level of leukocytes in the biomaterial.
Treatment can only be prescribed after assessment general condition women. An increase in the level of leukocytes is dangerous due to lightning-fast leukocytosis, which can lead to heavy bleeding. The cause of an increase in leukocytes is often thrush and pyelonephritis.
If the doctor cannot accurately determine the diagnosis and prescribes a course of antibiotics, it is not in your best interests to refuse. The health of you and your baby is at stake. There is no need to worry because any specialist will select a medicine that can be taken in your interesting position. Treatment will take approximately 7 to 10 days.
Increased protein levels
Increased protein in the urine of a pregnant woman may indicate developing gestosis, which is a serious pathology. Such a diagnosis can be made if a number of other signs are present. For example, edema and high blood pressure.
Normally, a urine test of the expectant mother may contain minor traces of the protein factor. If the amount of protein in the urine exceeds normal indicator at 0.033 g/l, it is necessary to consult a gynecologist and prescribe appropriate treatment aimed at reducing the substance in urine.
If an inflammatory process is suspected, antibacterial therapy is prescribed. If gestosis is confirmed, a number of recommendations are discussed: daily measurement of blood pressure, monitoring the appearance of edema, exclusion of fatty, smoked, and salty foods from the diet. In circumstances where there is a threat of premature birth, hospitalization in a hospital is necessary for a more thorough examination.
In order for pregnancy to bring joy, and not worries and worries, you need to carefully listen to your body. If you feel unwell, your urine has changed its primary color, or you have swelling, consult a doctor. This will help prevent unpleasant consequences incipient disease.
Urine testing during pregnancy is one of the main tests that every woman undergoes many times: at the beginning of her pregnancy it is carried out once a month, after 36 weeks - twice, and if necessary, even more often. What kind of indicators are doctors interested in in this analysis, which result can be considered “normal” and which should be alarming, how to correctly decipher the results of the study?
The main purpose of urine testing during pregnancy is to assess the state of the kidneys and urinary system, which bear an additional burden during pregnancy. However, there are a number of additional parameters by which serious disturbances in the course of pregnancy can be suspected in order to take urgent measures.
But there should be no renal epithelium in the analysis at all. If it appears, this indicates an infectious kidney infection, which must be treated as soon as possible.
Cylindrical cells (cylinders)
They are an elastic mass consisting of proteins, leukocytes, erythrocytes and epithelial cells. They really have the shape of a cylinder, since during formation they repeat the shape of the renal tubules, and then are washed out of them with urine.
The absence of kidney disease is indicated by the presence of no more than 1-2 hyaline casts in the field of view - this is considered the norm. But the appearance of any other cylinders can be considered a manifestation of kidney disease.
Bacteria and fungi
They also directly indicate the presence of an infection of the genitourinary system. Normally - none.
If bacteria do appear in the urine, then it is necessary to undergo an additional test - bacterial culture, and, if necessary, be treated with an antibiotic.
Salts
Urine itself is a solution containing a lot of salts, so their presence is not a pathology if all other indicators are within normal limits.
Too much urate may be in the urine due to dehydration or eating too much meat. Phosphates are a consequence of consuming foods containing phosphorus, and oxalates are a consequence of consuming foods containing phosphorus.
Slime
U healthy woman mucus in the urine is either completely absent or found in small quantities.
If there is a lot of it, this may indicate insufficient hygiene of the genital organs, but also the possible presence of infection.
A brief table of TAM norms during pregnancy will help to the expectant mother Be aware of your health and, if necessary, contact your gynecologist with questions. 
Conclusion
Now you know literally everything that a urine test can tell you during pregnancy, what the normal values should be, and you understand why this study is so important during this period. Some expectant mothers treat this analysis quite frivolously, not wanting to go to the hospital every time. antenatal clinic, and even in the morning. Thus, they deprive their doctor of the opportunity to identify an infection or disease on early stage and pick up effective treatment, which will not harm either the mother or the child. And advanced cases are always more difficult and expensive to treat.
However, a “bad” urine test does not always indicate serious problems. Usually, if the doctor is confused by something, he prescribes reanalysis(or additional research), and only if the second time the indicators are far from normal, the pregnant woman will be referred for consultation to a specialist, to a hospital, or she will be prescribed the necessary treatment.
The kidneys are a biological filter for all substances dissolved in the blood. They remove excess liquid, salts, toxic and waste substances. Therefore, monitoring kidney function during pregnancy is one of the most important tasks. To do this, regular urine tests are performed.
A general urine test is taken before each visit to an obstetrician-gynecologist at the clinic; additionally, other urine tests are performed as prescribed by the doctor. This is necessary in order to promptly identify abnormalities in the functioning of the kidneys, the inflammatory process, and the development of preeclampsia.
Urine during pregnancy.
In a urine test during pregnancy, the doctor will evaluate both physical and chemical indicators - color, clarity, presence of sediment, density (specific gravity) and pH, and inorganic urine sediment - the amount of formed elements, salts, microbes, protein.
The acidity or pH of urine will depend on diet: with a predominantly plant-and-dairy diet, the urine will be slightly alkaline, and with an abundance of meat, it will be acidic.
The specific gravity of urine indicates the degree of dissolution of salts and other substances (glucose, protein) in it. A sharp increase in specific gravity may indicate impaired renal function or the presence serious illnesses(diabetes, nephropathy).
How to donate urine during pregnancy.
The result can significantly depend on the quality of urine collection for analysis during pregnancy. Before donating urine, you should not eat highly coloring or diuretic foods (watermelons, melons, cucumbers), drink coffee, or take medications, which can affect the composition of urine.
Urine for general analysis is collected in the morning, immediately after sleep, after thoroughly washing the external genitalia with soap. Pee into a sterile cup or jar: only a medium portion is needed, approximately 30-50 ml. It must be brought to the laboratory within one to two hours to avoid distorting the results.
Main indicators and possible deviations from the norm in the analysis
Let's look at the main indicators of urine analysis.
Acetone in urine during pregnancy.
The acidity of urine changes during toxicosis with vomiting, causing both acidification of the urine and its alkalization, depending on the measures taken and the severity of vomiting. One of the signs of toxicosis and its fairly pronounced condition is the appearance of acetone (ketone bodies) in the urine. They change the pH of urine to the acidic side.
Cloudy urine during pregnancy.
If the clarity of urine is impaired, one may suspect the presence of mucus, microbes or leukocytes, protein in it, which indicates a serious inflammatory process in the kidneys or urinary system. The appearance of sediment may indicate urolithiasis or metabolic disorders.
Protein in urine during pregnancy.
One particularly alarming indicator in the urine of pregnant women is protein. In a healthy woman, it should normally be absent, but during pregnancy, especially in its later stages, traces of protein in the urine, determined by machines, are quite acceptable. They are designated in the analysis form by the term “trace”. These are features of the blood circulation of the kidneys and the result of increasing loads on them.
An increase in the amount of protein in a general urine test serves as a signal for a more detailed examination of the woman and a urine test for daily protein levels. An increase in protein levels above 300 ml (0.033 hl) may indicate the development of a serious pregnancy complication - nephropathy or. Also, the appearance of protein in the urine can be a sign of infectious and inflammatory kidney diseases - glomerulonephritis, nephrosonephritis. In such conditions, immediate hospitalization in a hospital, a comprehensive examination and treatment is necessary, and if the pregnancy is older and there is a progressive deterioration in kidney function, early delivery is necessary to save the life of the child and mother. Nephropathy leads to increased blood pressure, development dangerous complications in the form of preeclampsia and eclampsia, which can sharply disrupt the nutrition of the placenta, cause convulsions in the mother and death of the fetus.
Bacteria in urine during pregnancy.
During pregnancy, bacteria are often detected in a general urine test in women. This phenomenon is quite common and is due to the structural features of the genitourinary women's systems, proximity to the genitals of the rectum and weakening during pregnancy of the immune defense of the mucous membranes from microbial attacks. The appearance of microbes in the urine may be a defect in urine collection and a consequence of insufficient genital hygiene, or may be a symptom of a serious urinary tract infection - , cystitis. Escherichia coli or staphylococcus are especially common in urine.
A separate option could be asymptomatic bacteriuria: the appearance of microbes in the urine in the complete absence of signs of inflammation from the genitourinary tract. This condition requires close monitoring by a doctor, as it may be the initial stage of serious kidney and bladder infections. Asymptomatic bacteriuria with a large number of microbial bodies in a milliliter of urine can lead to premature birth, threat of miscarriage, intrauterine infection fetus, other complications.
If microbes are detected in a general urine test, additional urine culture is performed during pregnancy. This analysis is carried out according to general rules, but the urine is collected in a sterile cup and cultured on special media, detecting the number and type of microbes in the urine, as well as determining the sensitivity of these microbes to antibiotics.
Leukocytes in urine during pregnancy.
The presence of leukocytes in the urine indicates an inflammatory process in the genitourinary system. Depending on the type and number of leukocytes, the level of damage to the urinary system can be suspected. These may be the kidneys or the renal pyelocaliceal system, the ureters and bladder, and the urethra. When there are a large number of leukocytes in the urine, visible to the eye as lumps of mucus and flakes, they speak of pyuria (pus in the urine). This is accompanied by a serious condition for the pregnant woman, and is extremely dangerous for the fetus - it can threaten its intrauterine death, premature birth, placenta problems.
Red blood cells in urine during pregnancy.
The appearance of red blood cells in the urine is an unfavorable symptom, since Normally, they should be completely absent in a pregnant woman.. Blood in the urine can manifest itself as microhematuria, that is, a very small number of red blood cells. This happens with cystitis, urolithiasis, pyelitis, in initial stage gestosis. Sometimes blood in the urine is visible to the naked eye, which is called gross hematuria or “meat-slop-colored urine.” This occurs with nephritis, glomerunonephritis with nephrotic syndrome, with severe gestosis. These conditions are extremely dangerous for the mother and fetus and require immediate hospitalization and active therapy, and sometimes emergency caesarean section to save the baby and the mother herself.
Sugar in urine during pregnancy
If suspected or the level of glucose (sugar) in the urine is determined. When carbohydrate metabolism is disturbed, associated both with pregnancy itself and with the onset of diabetes, as a result of an increase in the level of glucose in the blood, its excess is filtered into the urine. Typically, an increase in sugar levels is accompanied by an increase in the density of urine, a sharp increase in the volume of urine excreted (up to three to five liters) and severe thirst.
Bad urine during pregnancy.
There are a number of conditions, the manifestation of which requires immediate consultation with a doctor or calling an ambulance. First of all this:
- acute decrease in the amount of urine up to its retention for more than 8-12 hours;
- the appearance of blood in the urine;
- severe turbidity of urine with fever, lower back pain, general malaise;
- cloudy urine combined with high blood pressure, double vision and swelling;
- passing large quantities of urine with great thirst, weakness and malaise.
