- What other reasons make getting a test necessary
- When a general urinalysis is given during pregnancy
- Types of urine tests during pregnancy
- Rehberg’s test
- Nechiporenko analysis
- Urine culture
- Zimnitskiy urinalysis
- Preparation for a urinalysis in pregnancy
- Important indicators and norms of values
- What other indicators the transcript contains
- Possible abnormalities and causes
- Bad urinalysis: what can be detected
- What is the need to control abnormal indicators
Taking a urine test during pregnancy, as well as many other mandatory studies – the key to maintaining the health of the expectant mother, the successful nurturance of the baby and its successful birth. It is no exaggeration to say that the control of a woman’s condition during pregnancy depends on the correct development of the fetus, the absence of complications at delivery, preventing the risk of abnormalities after birth.
While planning the pregnancy management, the gynecologist draws a schedule of tests by trimesters, which reflects changes in the woman’s body and corresponds to the stages of fetal development. It is important for the expectant mother to strictly adhere to the timing of tests, including the correct and timely delivery of urinalysis.
Tests: why they need to be taken
Objective picture of the state of health of a woman during pregnancy can only reflect the results of the processing of tests that will be timely delivered to the pregnant woman. This applies to the work of all organs and body systems, not only the expectant mother, but also developing in her fetus. Double load, which is experienced by the woman’s body during this period, is not always under his power, as may be evidenced by the figures of the main parameters that are monitored by the analysis of urine during pregnancy.
Kidneys, which perform the function of excretion of metabolic products not only of the pregnant woman, but also of the child, work twice as intensively during the period of fetal delivery. In addition, the active growth of the uterus leads to compression of the abdominal organs, among which are the ureters. Such a situation can cause urinary stasis, edema of the kidneys, infection rising to the kidneys from the bladder.
What other reasons make getting a test necessary
Important reasons that make urinalysis during pregnancy necessary are a weakening of the immune system and hormonal changes that lead to relaxation of the ureters. This has a provocative effect on the infection process, exacerbates chronic diseases of the urinary system.
In addition, urinalysis during pregnancy is appointed for the purpose of timely diagnosis of pathological processes occurring in the urinary and other internal systems and organs; control the course of the disease identified, the development and continuous assessment of the course of the therapy undertaken.
The study will not miss the warning signs of late toxemia (gestosis), which is dangerous to the life of the expectant mother and her baby A urinalysis in pregnancy, in conjunction with specific symptoms helps to identify the degree of gestosis, to prevent the occurrence of pathology.
When a general urinalysis is given during pregnancy
A woman expecting a child, in almost every visit to the gynecologist gives any tests. However, the most frequently prescribed laboratory study is a common urinalysis during pregnancy. And it occurs not only in the early stages of pregnancy, but also increasing numbers up to the moment of the birth of the baby.
The plan for taking this test for a pregnant woman is as follows:
- First trimester – once every four weeks;
- Second and beginning of the third trimester – once every two weeks;
- Beginning in the 35th week, weekly.
In general, as a rule, a woman during pregnancy gives a urine sample at each visit to the gynecologist, starting from the first visit to the clinic to determine the fact of pregnancy and registration, and to the moment of delivery.
Types of urine tests during pregnancy
In addition to taking a general urine test during pregnancy, there are other types of urine tests. They are prescribed in cases where the urinalysis contains bacteria in order to determine their number, type and susceptibility to antibacterial agents, as well as when there is a need to determine leukocytes, red blood cells, when there is a suspicion of gestosis, and in some other situations. For such studies, as well as for general analysis, requires careful preparation, so that the results of the study were the most reliable.
Such special urine tests in pregnancy include studies:
- Reberg’s test
- urine culture;
- by Zimnitskiy.
For each of these types of tests there are algorithms of how to collect urine for the study, as well as standards of values of the studied parameters.
This method of urine analysis is designed to determine the ability of urine filtration by the kidneys and is prescribed for diabetes, urinary tract infections, gestosis, kidney disease. Urine is collected in a single container over the course of a day and stored in the refrigerator during the collection time. After the process is completed, the contents of the container is measured, it is mandatory to mix and pour into a jar or special container of 70-100 ml.
The urine is then taken to the laboratory. At the time of delivery, you will need to report what the total volume of urine collected during the day. To take this test correctly, you need to avoid coffee and strong tea, and exclude vigorous physical activity. After receiving the results and comparing them with the normative, if there is a deviation from the norm, the conclusion is made about a decrease in the level of renal filtration, which confirms kidney damage in severe complications of pregnancy.
This urinalysis in pregnancy is appointed to determine in 1 ml of substance leukocytes, erythrocytes, cylinders in order to detect an inflammatory process in the organs of the urinary system of the pregnant woman, the deciphering of the general analysis showed changes. The examination provides results with greater reliability than the usual general analysis, in addition allows you to monitor the assigned and ongoing therapy in the dynamics.
In pregnancy, the norm of urine analysis by Nechiporenko in 1 ml – white blood cells – less than 2 thousand, erythrocytes – less than 1 thousand, cylinders – less than 20. An increase in the normative indicators usually indicates the presence of pyelonephritis, glomerulonephritis, diseases of the cardiovascular system, arterial hypertension, respectively, in the expectant mother.
If a general urinalysis reveals bacteria, its culture is carried out in order to determine the number of bacteria, their type and sensitivity to special drugs.
Getting the right result will ensure that the collection of urine with a cotton swab closed in the vagina, and only after a thorough toilet of the external genitalia. In this case, a medium amount of urine is collected in a sterile container and brought to the laboratory within one and a half to two hours.
It takes an average of 7-10 days to get the results and for the doctor to decide whether antibacterial treatment and the choice of drugs are necessary. Until the results of the culture, if there is a clinic of inflammation, antibacterial therapy with a broad-spectrum antibiotic is carried out. If the course of the disease is asymptomatic or the symptoms are expressed mildly, treatment is not carried out until the urinalysis data are obtained.
This urinalysis is performed to detect hidden edema, to clarify the ability of the kidneys to concentrate and dilute the urine. It is usually required if there is suspicion of diabetes mellitus, the development of gestosis, renal failure, with infections of the urinary system. To properly collect urine for the study, the collection is carried out within 24 hours in 8 containers, taking into account the volume of liquid consumed, including fruits, vegetables, soups. No urine is collected at 6 am, after that all subsequent urine is poured into signed containers with a clear schedule and a three-hour period – from 6 to 9 am, from 9 to 12 and so on with the last collection between 3 and 6 am. The norm, among other things, is considered to be:
- priority of daily urine output;
- daily volume of urine – within 1.5 liters;
- urine output of 70-80% of the liquid drunk during the day.
Deviations from the established characteristics are evidence of renal dysfunction.
Preparation for a urinalysis in pregnancy
The process of preparation for the analysis during pregnancy includes the usual restrictions, as well as a number of hygienic procedures. Thus:
- Within 2 days before the collection of urine, the intake of diuretics is excluded;
- The day before the collection of biomaterial refrain from drinking alcohol, fruits, vegetables, red wine, multivitamins that affect the color of the urine, and exercise;
- Refrain from sexual intercourse for half a day before passing the urine test in pregnancy;
- Just before the collection of urine toilets the external genitalia, to prevent the risk of vaginal discharge in the biomaterial placed in the vagina cotton swab;
- at the first urination in the morning collect an average portion of urine (collection is possible during the day at any time).
In addition, it is advisable not to touch the body with the container when collecting the biomaterial. Delivery to the medical facility is desirable within 2 hours after its collection.
Important indicators and norms of values
The study of urine analysis in pregnancy is carried out to evaluate various parameters. Without the use of equipment, organoleptic properties are evaluated. The color should be straw or bright yellow, the odor – unobtrusive specific, transparency – absolute, there should be little foam when shaken.
As for other characteristics, their normative indicators reflect the table, which shows the standard deciphering of some indicators of the analysis of urine in general:
|Indicator name||The norm of the indicator|
|Density||1,010 – 1,025|
|Protein||none or 0.033 g/l|
|Bilirubin||none or up to 8.5 μmol/L|
|Glucose||none or up to 1 mmol/L|
|Erythrocytes||Up to 2 in p/z|
|Ketone bodies||none or up to 0.5 mmol/l|
|Urobilinogen||none or up to 35 µmol/L|
|Leukocytes||up to 5 in p/z|
However, it is best to discuss the transcript of the test indicators with your doctor.
What other indicators the transcript contains
In addition to the main indicators, among what the urinalysis shows in pregnancy,
may detect squamous epithelium – superficially located skin cells of the external genitalia, the detection of which in the biomaterial has no diagnostic value. Transitional epithelium can also be found – located in the upper part of the urethra, bladder, ureters, kidneys. Single cells may be found in the urine sediment in healthy people.
Their large number indicates intoxication, jaundice, chronic cystitis, renal stone disease, occurs after surgical interventions on the urinary tract. Detected renal epithelium may be a consequence of the presence of nephritis and nephrosis. Bacteria in the biomaterial indicate the presence of urinary tract infection, if there is no contamination of urine with bacteria from vaginal secretions and from the skin.
Possible abnormalities and causes
Urinalysis in pregnancy is not always “good”, that is, it happens that the main indicators do not meet established medical standards. Typically, such deviations in some items are evidence of developing or pre-existing serious diseases that may not only have a detrimental effect on the health of the expectant mother and her baby, but also pose a direct threat to their lives.
Such abnormalities have their own reasons. However, in some cases, the detection of discrepancies in the normative values is not a consequence of progressive disease, but occurs only because of the fact that the rules of how to pass urinalysis during pregnancy have not been followed.
Bad urinalysis: what can be detected
If the tests performed in the early term or in the last trimester revealed, for example, ketone bodies, the reason for their detection may be the decompensation of diabetes and the risk of developing a hyperglycemic coma. The presence of acetone in the urine test is a consequence of serious diseases of the digestive tract, blood, and liver. Glucose in the urine may appear due to impaired carbohydrate metabolism, indicating the development of pregnancy diabetes.
Combined with high blood pressure and edema of the shins, face, hands, the increased protein level indicates that the pregnant woman is developing gestosis, when the developing fetus is deprived of the necessary amount of nutrients and oxygen supply. The reason for the presence of mucus in the biomaterial may be the presence of a chronic inflammatory process in the urinary tract.
What is the need to control abnormal indicators
If the analysis, which was taken by a pregnant woman, is far from good indicators of the studied parameters, the doctor analyzes each position separately and the overall situation in order to properly assess the condition of the pregnant woman and her fetus. Then a treatment concept is developed, medications are prescribed and the patient’s condition is monitored.
Even in a healthy woman in a normal state of urine composition varies significantly depending on the mode of drinking, eating, taking medications. Constant monitoring of this composition in accordance with the existing schedule of biomaterial collection will keep under control the main parameters that characterize the health status of the expectant mother and her child. This is necessary to sound the alarm in time and take urgent adequate measures.