Protein Question/Delivery?

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Protein Question/Delivery?

Postby naomihope427 » Wed Sep 01, 2010 10:05 pm

I was wondering, at what amount would a doctor say enough is enough with the amount of protein in the urine and go for delivery?

I am at a mild case of preeclampsia, blood pressures have been good so far, 1 or 2 high ones. No other symptoms, still in hospital bedrest, most likely until remainder of pregnancy. Was told though if he sees anything fishy he would then deliver, wouldnt take chances and let me get severe.

With my first born, I had a 2+ protein on the Friday I was admitted and it jumped to 6+ on that Monday morning and that was delivery STAT. I was very swollen.

My last 24 hr was 690, up from 400+. I will be doing another 24 hr in the morning, so will know results Friday morning.

Thank you for your help!!
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Re : Protein Question/Delivery?

Postby trish » Wed Sep 01, 2010 11:41 pm

I'm certainly not a Dr. but my understanding is that it's not a certain level of protein that is the deciding factor in delivery - rather other symptoms that make them decide that delivery is the best option. But everyone is different so I'd just ask your Dr. what protein amount would make him want to deliver. Hang in there!!
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Re : Protein Question/Delivery?

Postby kerisue » Wed Sep 01, 2010 11:56 pm

when my docs found protein in the urine they did additional (blood) testing. The protein in the urine prompted the pe diagnosis (along with my blood pressure) and prompted the testing, but it was the results of the blood tests they were actually concerned about.
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Re : Protein Question/Delivery?

Postby sarah0381 » Thu Sep 02, 2010 09:51 am

From what I've read docs won't actually deliver because of protien alone unless its 5,000 or more in a 24hr protien catch. Good luck!!!
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Re : Protein Question/Delivery?

Postby blythe » Thu Sep 02, 2010 11:41 am

5000mg or more in 24 hours is part of the diagnostic criteria for "severe" PE - but I know Caryn was spilling 17,000mg and it was fetal indicators that got her delivered, not the level of protein.

Ah - found the reference I was remembering:
http://www.ncbi.nlm.nih.gov/pubmed/17229328
"LEARNING OBJECTIVES: After completion of this article, the reader should be able to state that measurement of urinary protein levels by simple techniques are not sensitive or specific, recall that both hypertension and proteinuria may be absent in patients with preeclampsia, and explain that proteinuria is not predictive of adverse outcomes and that delivery should not be based on protein excretion alone."
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Re : Protein Question/Delivery?

Postby klutsyone01 » Mon Sep 06, 2010 09:01 pm

Blyth, i would love some clarification. So not all of us spill protien or we might not until the very end when we are pretty bad off? So in the absence of Alot of protien what is a big tip off?
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Re : Protein Question/Delivery?

Postby caryn » Mon Sep 06, 2010 09:42 pm

At the moment, theoretically, they treat "being pregnant" plus any of the other symptoms, or a maternal report of general discomfort, as a reason to investigate further. Increased bp or bad bloodwork or a headache or decreased fetal growth or decreased fetal movement or brisk reflexes or unusual swelling usually trigger some sort of followup.

Soon they will be able to test bloodwork for the levels of two proteins and the rate at which they are changing and be certain that you have PE -- or even that you will develop it before 34 weeks gestation. But right now that test is still in development.

High protein alone isn't a reason to deliver because the group of women (and babies) with crazy protein readings doesn't actually do worse than the group with mildly elevated readings. Delivery is usually timed by things like escalating unresponsive blood pressure, or the sorts of reflexes that make them worry about seizure, or a fetus who's becoming unresponsive, because in those groups there's a clear benefit to delivery. It turns out that you can have crazy proteinuria and not really be threatened by it, though, plus it reverses after delivery.
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