24 hour urine what's ok ?

[holly3372@msn.com]

So at 7 weeks I did a 24 hour urine test and was at 143. I am now 11 weeks. Wondering, when should I ask for another one and what numbers are normal? I always thought anything above 300 wasn't good but below was ok? What's what?

[alviarin]

I believe that in terms of 24 hour proteinura in pregnancy:
0-150 mg considered normal
200+ mg watch patient more closely, especially if normal baseline is low
300+ mg plus 2 high blood pressure readings at least 6 hours apart diagnostic criteria for preeclampsia
5000+ mg or 5+ g indicator of severe preeclampsia

Some women spill a little protein even when not pregnant, so they look more at the changes in proteinura compared to normal non-pregnant or early pregnancy baseline.

My early pregnancy 24 hour urine came back with 240 mg protein but my OB wasn't concerned since some increase can be normal due to pregnancy. She doesn't plan to run another 24 hour urine until 32 weeks, or unless new symptoms pop up, I get a positive on a protein dipstick test, or my pressures start trending higher.

[blythe]

I've heard similar information from other women here - that their doctors take their baseline protein spillage into account to determine a PE diagnosis / when they are getting sick.

I don't have a good handle on when to repeat the 24-hour, it seems like the 24-hour collections are most important for diagnosis, because after that they can rely on the dips to see when your proteinuria has increased a lot. That's a complete guess though, I'd be interested in your doctor's answer and other women's experiences.

I've seen similar breakdowns to what Alviarin listed. I've heard docs say that anything below 300 is normal, and I've also heard docs say anything above zero is actually *not* normal, just not enough to do anything about medically. If I'm remembering right, women who spill protein in the first trimester have been told that they probably have a mild underlying kidney disease or dysfunction that is either always there and no one does 24-hour collections normally so they would never know otherwise, or that the physical demands and changes of pregnancy "unmasks" a mild kidney disease / dysfunction. Does that match what your docs have said for your case?

One thing to be aware of, spilling protein this early is a risk factor for PE. Not a guarantee you'll get sick, but another risk factor. I'm assuming you're seeing an MFM already? I'd ask if a consult with a nephrologist would be appropriate.

[MomTimesThree]

I also had 'high' levels (194) at 10 weeks. We did our first repeat 24 hour when other symptoms were present, like worsening BP.

Like the previous poster said, our doctors mentioned that because we were already spilling we probably had an underlying condition causing it, or had done damage to our kidneys in our last pregnancy.

Our MFM also told us that because we were higher to start, that although 300 was diagnostic, they wouldn't really be as concerned until it was "significantly" higher, which he also said was very subjective since "significantly" higher isn't a number and can change depending on provider.

[holly3372@msn.com]

Thanks so much girls. Seems lots of us that get a baseline are a bit elevated to start. Yes, I will be seeing an MFM but not until 16 weeks when I will get my amnio done. I also see my Ob on August 10th so will ask him to go over my labs again and expalin in detail. So scary, I am so early still so much ahead. Thanks again