by angieb (1193 Posts), Thu Jun 21, 2012 04:51 pm
No protein in your urine in an in office dip test means NOTHING. One of my friends had an appointment just last week and had no trace of protein in the office sample, but when she did a 24 hour urine test (which her doctor ordered because she had other signs of pre-e), it came back at 250 mg (pre-e is diagnosed at 300 mg and two readings of 140/90 or higher.) We tell people this all of the time here, but even I was surprised at how high her 24 hour urine came back without even showing a trace in the office test. Request a 24 hour urine tomorrow (or demand it if you have to. Tell them you would like it noted in your medical records that you requested a 24 hour urine and that they have declined.) It drives me crazy that doctors don't order this when there are other symptoms of preeclampsia present. It is a cheap test, a pain in the butt for you to do, but a very basic standard of care. (Disregard this if you have done a 24 hour urine test and it came back clear, that's another matter altogether, but from your post it sounds like you just did an in-office sample. A 24 hour urine is where you collect all of your urine for 24 hours and then turn it into a lab so they can measure how much protein your kidneys are spilling, if any.)
If you are heading towards pre-e at 24ish weeks, which it sounds very possible you are (I had severe preeclampsia and HELLP at 23 weeks, our daughter passed away shortly after she was born, it is *very* possible to get it this early.) You should be seen by a Maternal Fetal medicine specialist or perinatalogist, someone accustomed to working with high risk pregnancies, not just a regular OB. I would also request steroid shots sooner than later. There are some women who end up delivering within days or even hours of being diagnosed. And then there are women who are diagnosed but manage to stay pregnant for several weeks and even months before they have to deliver. Since you don't know how rapidly it might progress and right now you are near diagnosis-levels in the micropreemie gestational age range, you absolutely positively want to get steroid shots to help develop the baby's lungs before you deliver, if there is time. Timing them is tricky because they are two doses 24 hours apart and need 48 hours to work, but ideally you want to get them as close to delivery as possible. I would err on the side of getting them too early vs. possibly not being able to get them at all. (In cases like mine, I was admitted to the hospital at 3am, our daughter was born at 8:48 pm that same day, no time for even 1 dose of steroids because it was so emergent.) Steroids are no guarantee, but they make a huge difference in the survival rates of micropreemies. Definitely keep an eye on your blood pressure at home.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/