Understanding proteinuria

[azrood]

I have posted here a few times previously and have found your responses to be tremendously helpful. I am hoping that you can help me understand my current situation a little better. To make a long story short, my medical care at this point leaves much to be desired and at my 32 wk appt my bp was 145/95 with no protien, but hypereflexia. Then at my 33.5 wk appt., my bp was initally 130/100, but went down to 130/80 in about 15 minutes, again I had no protien. Anyways, my next appt. isn't until 36 wks so I purchased urinalysis test strips to check for protein on my own. Within a single day, I will get readings that vary from trace to +1 (which I understand can be due to the concentration of my urine). My home bp readings have been low averaging about 120/75 with the highest being 130/88. My question is when to worry about the protein? At what point should I worry? Do I wait until I reach +2 (which I believe I read is the point of diagnosis for pre-e along with other factors)? Any insight you have to offer would be much appreciated!

Jaime

dd 8-28-02
edd 1-6-04

[mada]

Hi Jaime,

When your blood pressure came down, did they have oyu lying dowm for a while befor they took it again? And where they taking it with you laying down or sitting up? Many times I have read on this board that a true reading is with you sitting up...And that it's typical with the beggining of PE to have fluctuating BP's from high to low....So, I guess what I am trying to say is that typically, a diagnosis of preeclampsia is, elevated Bp's and a reading of +1 protein or higher. That's what my doc told me. I would ask my doc for a 24 hour urine analysis ( you have to pee in a big ol' jug for 24 hours[xx(]) but it's much more accurate and have a blood test done to check various things..ie. kidney and liver function, platlets, uric acid....It's better to be safe than wait for the "perfect sign"....I hope this helps.. As you know PE can go from mild to severe quickly, so please take good care and let us know how you are doing...

Mada Harpster

Sam 6-29-00 36weeks P.E.
Ben 11-03-01 No P.E.

[laura]

They don't want to see you until next month?? Huh? No testing no BP checks? Hmph. I'm indignant on your behalf.

I also agree with Mada- I'd ask for the 24 hour urine, that's the only way to really know what's going on regarding proteinuria.

I think a +1 is plenty enough to be worried about, but if you hit +2, you go in right away! And don't forget your kick counts, either.

Hugs, and take care...


Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/

[akemt]

Jaime,

I had high blood pressure but never the PE protein ammount. Pregnancy Induced Hypertension (PIH) is bad enough in and of itself and I would think they should be monitoring you more than once a month! I was going in twice a week when I was diagnosed, once for an ultrasound, urine and BP check and the other time for labs, BP check and an non-stress test (NST). I cannot be sure how much of that was strictly for the BP or for the Oligo caused by the BP. Have they done any testing yet other than urine? When my blood pressures went up, I was sent in for labs and an ultrasound to make sure it wasn't causing any problems yet...and it already was with just fluctuating bp's. Seems like I mention this alot! I hope I haven't told you twice now! LOL It is better safe than sorry in my book. I know that as soon as my BP starts fluctuating in my next pregnancy I will be hitting that doctor up for tests and will DEFINATELY be making them check my amniotic fluid levels just to be sure there is no repeat of last pg. Perhaps a bit overcautious, but oh well!

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo

[annegarrett]

And SHE is in a little town in Alaska!

:)

Anne Garrett
Executive Director
Preeclampsia Foundation

[azrood]

I am SOOOOO glad that I found this board! Sometimes I feel like I am overreacting since my doctors (all of them!) have such a laid back attitude about all of this, but when I read your stories and advice it makes me feel like I am doing the right thing by being proactive.

To answer some of your questions -

Typically when I have a high bp reading, the dr. will have my lie on my left side and then takes my bp again while I'm lying down, but with the 130/100 they had me wait 15 min. sitting up and took it again. At my last appt, I discovered that only the lowest bp they get is recorded in my chart!

The only other test that they have done besides the normal urine dip stick test for protein was a non-stress test at 32 weeks when I had the 145/95 bp. The first 20 minutes, they didn't like what they were seeing so they had me do it for another 20 minutes or so and said that it was fine and that the baby was probably just sleeping in the begining.

Thanks for all of your help!

Jaime

dd 8-28-02
edd 1-6-04

[akemt]

Jaime,

I would hope that you can get an ultrasound done shorty, just to be sure. I had no symptoms of low amniotic fluid...I don't know that there really are any! And, I would definately advise that you have them take your bp upright and write down ALL blood pressures and how they were taken/when in your chart...here is a link about how BP should be taken with the opinions of our Experts:

http://www.preeclampsia.org/forum/viewtopic.php?t=321

I suggest printing it off and taking it with you. Ask them why, if the experts in the field (and it gives their name and place of practice) suggest upright BP's are they making you do them laying down and not even recording your higher BP's. Maybe that is a bit forward, depending on your doctor, but don't let them just brush you off. I had been sent home weeks before my actual diagnosis by another doctor who didn't even look at me because my BP of 150something/100 something went down while laying on my side for a half hour. I wonder had they paid attention then, would my amniotic fluid have even gotten so dangerously low? Luckily, when I went in for my regular appointment and was seen by my regular doctor, while he also did blood pressures in a reclined position, he appreciated that they weren't always the best measurement and atleast had me take one a day upright. Had I known all I do now, I still would have required more, but I was very glad for what he did for our family. In fact, I'm pondering sending him that post from the experts...lol I should send it to every doctor in that practice as well as the OB wing (they were the worst about BP taking, I swear!)! Okay, I feel my self getting a bit riled up so perhaps I should end this email. [;)] LOL. Thanks for listening to my rant...I really hope you require appropriate treatment from your health care providers. I know it is hard to make them listen and agree sometimes, but I think the more doctors and nurses we reach, the better off the people who come after us have it and the sooner everyone will know the appropriate steps to take!

This seems long now! [:I]

Jaime, thanks for responding! We love to hear back from ladies with questions...let us know how things are going!


Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo

[akemt]

Laura,

Did I say something wrong again? LOL Sorry!

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo

[annegarrett]

She fixed a typo! We do that sometimes...

Anne Garrett
Executive Director
Preeclampsia Foundation