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509 Protein in Urine with questions

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509 Protein in Urine with questions

Postby Mrsdrose » Wed Aug 29, 2012 10:50 pm

by Mrsdrose (1 Posts), Wed Aug 29, 2012 10:50 pm

I went into l&d with severe upper right quadrant pain and they could not pinpoint the issue, however they sent me home with a 24 hour urine test that came back with a 509 for protein. My blood pressure was 145/80, so my doctor said to be careful. Is this common? And what symptoms do I need to watch for? Is there anything I could be doing at home to help? I'm currently 28 weeks and this is my first, so I'm a little more concerned now after researching than I was in the dr.s office. Thanks in advance.
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Re: 509 Protein in Urine with questions

Postby tree » Wed Aug 29, 2012 11:43 pm

by tree (819 Posts), Wed Aug 29, 2012 11:43 pm

Welcome to the forum.
Did they do any blood tests while you were in L&D? Upper right quadrant pain can be a sign of HELLP, and they use a simple blood test to determine if your liver is causing the pain.
It is difficult to confirm or rule out HELLP without the blood test because so many things can cause abdominal pain in pregnancy. Some of them (e.g. a foot or heartburn) are normal, but you really want to be certain about what is causing the pain when you have other signs of preeclampsia.

How are you feeling? It sounds like you are very close to being diagnosed with preeclampsia (requires protein greater than 300 mg and blood pressure over 140/90). It is possible to develop HELLP without ever meeting the diagnostic threshold for preeclampsia.

It is really important to keep track of your symptoms and report any changes to your doctor or L&D. The "red flag" warning symptoms include a headache that doesn't go away with tylenol, nausea, generally feeling bad, upper right quadrant pain, visual changes, and swelling in your face or hands. A more complete list is here:
http://www.preeclampsia.org/symptoms.asp

How often are you being seen by your doctor? Many of us are more comfortable being monitored more closely and more often since preeclampsia can move quickly in some women.
Daughter born April 2009 at 35 weeks due to Class 1 HELLP
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Re: 509 Protein in Urine with questions

Postby angieb » Thu Aug 30, 2012 09:21 am

by angieb (1192 Posts), Thu Aug 30, 2012 09:21 am

Upper right quadrant pain can be HELLP syndrome which is extremely serious, even fatal if not diagnosed/delivered in time. I developed it with normal blood pressure and no protein in my urine, so the fact that your blood pressure wasn't in the pre-eclampsia range yet doesn't rule it out.

Did they do bloodwork? When I went in with severe upper right quadrant pain, they did bloodwork shortly after admitting me-this was after I'd been in pain all night, and off and on for weeks prior, my blood work initially came back "almost normal" with my liver enzymes just "slightly" elevated. They decided to keep watching me and sent me for an ultrasound on my organs anyway, then re-did the bloodwork 6 hours later. In those 6 hours my pain didn't get worse, but my liver enzymes more than doubled and my platelet levels dropped by 100,000. We ended up delivering that evening as things continued going downhill from there. Later on, my OB told me that I probably would have came back in seizing or worse within a day or two if they had sent me home after the initial bloodwork was almost normal. (And like I said, my pain actually came and went for a couple of weeks prior to the time it got so bad I went to the hospital. During the time I was in the hospital, even though my bloodwork got worse, I didn't feel worse or better.)

If they haven't done bloodwork and you still have pain, I would insist on getting some bloodwork done. (Specifically for your liver function and platelet levels especially.) If that means going back to L&D, go back to L&D, even a different hospital if you think they may take you more seriously.

Upper right quadrant pain can also be caused by gallbladder issues/gallstones, and HELLP can often be mistaken for it. But URQ pain combined with your protein in your urine and your borderline blood pressure, I'd be pretty concerned.

For what it's worth, I've since had a normal pregnancy and am almost 29 weeks into my third pregnancy, both have so far been normal, I have NEVER, even for a minute, felt anything like the pain that was off and on for weeks when I had HELLP in my first pregnancy. And DS was a pretty big baby. Definitely it was uncomfortable at times, but severe pain? No.

You can check out the HELLP section of this forum for a description of the upper right quadrant pain by others who have been diagnosed with HELLP, it differs a bit for everyone.
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/
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Re: 509 Protein in Urine with questions

Postby lemons » Thu Aug 30, 2012 02:53 pm

by lemons (75 Posts), Thu Aug 30, 2012 02:53 pm

Just wanted to clarify that with the information that you provided, you may have in fact already reached the diagnostic criteria for preeclampsia. When we talk about BP being 140/90, we are actually saying that if either the top number is over 140 OR the bottom number is over 90, then you blood pressure is considered "high".

And now quoting myself from an older post: In the presence of greater than 300 mg protein in a 24hr urine catch-
"Since the systolic and diastolic blood pressures are measuring different phenomenon in your body, the diagnostic criteria for PE is if EITHER the systolic is 140 or greater OR the diastolic is 90 or greater. Because the systolic and diastolic BP are inter-related, most times the two numbers will increase together so that most hypertension has both numbers at or greater than 140/90."

I agree with the previous posters to please watch your symptoms very carefully and feel free to call your OB with any questions that you may have about when he/she wants you to call in, when to head back to L&D, and what you can expect in terms of monitoring and follow-up care. Again, PE/HELLP can be very fast moving. At a minimum, if I were in your shoes, I would be calling my OB to ask about whether or not it is prudent to start a round of steroids.
Diana, happily married since 2007.
Miscarriage at 10 weeks (June 2009).
DD at 30+0 weeks weighing 2lbs 9oz (October 2010) due to PE and IUGR. Today, a happy and healthy toddler.
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