# Protein in urine



## emmadaffodil

I posted on 'ask a nurse' a few days ago, but I think this is a better place for my question.

I am 37 weeks pg. I went to the hospital a couple of days ago for a scan (suspected breech, actually the right way round). Whilst I was there they did a standard urine test and found protein in it. The doctor said it was level 3 and that this was quite high. I don't have any other symptoms of pre-eclampsia (no high BP, headaches, swollen limbs etc) or of a urine infection though. They took some blood and more urine (after making me drink lots of water) and sent this away for testing. They told me that the results would be back yesterday, but I've just phoned and they now say not until tomorrow or Monday.

This morning I tested my urine at home using some of the strips that test both glucose and protein levels (I'd had a scare with glucose levels a few weeks ago and my midwife had given those to me). This again shows a level 3 of protein. I spoke to a midwife at the hospital this morning, but she didn't seem to think that any results from home-testing would be reliable. 

Should I be worried about pre-eclampsia? If it isn't that, what else could it be? I feel a bit anxious about it all today because I'm feeling really tired and a bit nauseous. I am due to see the community midwife tomorrow though.

Emma


----------



## fitou

Emma, 

If you are concerned try and see your GP this afternoon and take a sample with you or ring the hospital and ask to be seen.  It is better to put your mind at rest than worry.  I was given test strips at home by one midwife and told to test daily because I had other symptoms and traces of protein.  They showed protein so was sent to assessment unit but sample there was negative and they couldn't believe that I had been left them to do myself, so the response you got it not unusual. 

All the best,
Fitouxx


----------



## jan27

emma

3+ of protein is a lot and does seem unusual.  Preeclampsia needs any combination of two of three main sysmptoms, raised BP, swelling and protein. Headaches and 'floaters' in the eyes are a symptom of raised BP and common in pre eclampsia. The fact that you only have protein is positive.  There could be contamination from discharge etc but could be a Urine infection which in pregnancy you may not be aware of usual symptoms.  

When you see your midwife tomoorow she may be able to contact the lab for a verbal result, however if you are really concerned please see your GP and explain your worries, it may well give you peace of mind.

Hope that helps

Jan


----------



## emmadaffodil

Jan,

Thank you for getting back so quickly, and welcome to FF. It is great to have this 'ask a midwife' board.

I'll see what the midwife says tomorrow, and see if she can get any sense out of the hospital. I can always try to see a GP whilst I'm at the surgery if need be. I hope it is just a urine infection. If it is, would I need anti-biotics? Is there anything else I could do to get my protein levels down. Sorry if this seems a daft question, but should I be avoiding foods that are high in protein?

Emma


----------



## jan27

Hi emma

if you have a urine infection you will need antibiotics, but don't worry this is common in pregnancy.  If the protein is persistant they may do additional tests but i would not worry about it in the mean time as long as everything else is well.

Good luck tomorrow

Jan


----------



## emmadaffodil

Hi Jan,

Just been to see the midwife. She reckons it can't be a urine infection because the urine is clear rather than cloudy. They're admitting me to the hospital today, but I don't know for how long. All very scary.

Emma


----------



## Betty M

Hi Emma

Sounds from what you have said and Jan too that you should be fine. Hopefully the hospital will confirm just that.

You using your strips at home as just as reliable as the midwife doing them in a hospital if you have your mid-stream pee in a container and leave it in for roughly the same time as the midwife. Its the same strips after all!!

You are probably going to a day assessment unit - they will monitor your BP, urine and the baby to check if you are ok and ask you lots of questions about the other poss headache symptoms. They will also hound the lab for the results.  Urine infections are very common so it could just be that.

I have a kidney condition which means I regularly have 2+ or 3+ protein in my urine (regardless of what I eat - it is your kidneys failing to deal with protein properly rather than an overdose of milk/steak!) which in my first pregnancy had me off in the day assessment unit on a regular basis from week 34. I did get slightly elevated blood pressure as well but not pre-eclampsia proper so it is certainly not a dead cert that you will get it by any means.  I did in the end have an early induction at 38 weeks to which the hightened risk of pre-eclampsia contributed but was not the primary reason. 

The key is that if it is an early sign of heightened riosk of pre-eclampsia you are going to totally the right place.
All the best .
Betty x


----------



## emmadaffodil

Thanks Betty,

It is reassuring to hear of other people who have been through the same thing.

I'm still a little confused as to what is going on with me. They monitored the fetal heart-rate and movements and my BP, and they were all fine. They took some blood, and the results come back tomorrow. At one point they said they'd keep me in for observation for 24 hours and induce labour if the protein problem didn't clear up, but then they changed their minds. They've sent me home with a huge plastic bottle in which I have to put all my urine over the next 24 hours, then return it to them. Lovely!

They say it doesn't seem like preeclampsia or a urine infection, so goodness knows what is going on. One midwife said I was producing a lot of urine, whereas if I had either of those things I'd have very little. 

I hope they can give me some straight answers soon. I hate all this uncertainty.

Emma


----------



## Betty M

Emma

Ahh the 24 hour urine bottle - I know those well! I get to do them every 4 months or so. Travelling on the underground with lots of urine sloshing around in a bottle in a plastic bag is super! It gives them a better idea of your "creatinine clearance" - another kidney related thing.  Its all precautionary and you should try not to worry - if they were worried they would have kept you in for sure. 

Hope it all goes well.  Let us know how you get on.
Betty x


----------



## emmadaffodil

Thanks again Betty,

I delivered my vat of urine this afternoon. I don't envy you doing that on the tube. I was terrified that the bottle would come open and spill all over the car. 
I have to go back on Tuesday to see my consultant, and hopefully he'll be able to tell me what is going on.

Emma, xx


----------



## emmadaffodil

Thought I'd better provide an end (of sorts) to the story. I saw my consultant this afternoon. He says that the afterbirth is threatening the normal functioning of my kidneys and so has to come out, along with the baby. I'm going to be admitted on Thursday for induction. I was hoping to avoid that (I'm moving house next week ), but it doesn't look like it can be avoided.

Emma, xx


----------



## jan27

try and have some acupuncture as this helps to induce labour.  You could also ask midwife to tey and do membrane sweep.  This may not be possible if cervix is unripe but worth a try if you are...Good luck

Jan


----------



## emmadaffodil

Lovely as acupuncture sounds, I don't think it is an option. I'd have to do it tomorrow (last day of freedom) but I don't want to risk anything kicking off before Thursday; my dh is away in South Africa and gets back on Thursday.

Is a membrabe sweep very unpleasant/uncomfortable?


----------



## jan27

membrane sweeps can be uncomfortable, but alot kinder to go into spontaneous labour than medically induced.  You would need to have this tomorrow to give it time to work.  It would be worth a go any way, nothing to lose....

Jan xx


----------



## emmadaffodil

Jan,

Sorry to keep bothering you with my questions (but I'm so glad you're there). When you say that a membrane sweep and spontaneous labour is kinder than medically induced labour, what does that the latter involve that makes it so awful? The consultant made it sound like it was just like normal labour but with more waiting around at the start. I was too shocked at the time to ask sensible questions. I'd like to prepare myself for the worst that can happen and know as much as possible about the horrific side of things.

Also, my MIL (ex-midwife but many years since she practiced so perhaps unreliable) reckons that there's a higher chance of having a c-section following induction too. Is she right?


----------



## Betty M

Emma

Jan is better placed to answer your specific questions than I am but I thought I would give you my induction story in case it gives you some encouragement. 

I was induced at 38 weeks - they told me the week before.  I had two sessions of acupuncture that week. It didn't bring on labour at all but I was starting to dilate when I went into hospital which could have been the effect of the acupuncture. I did not have a membrane sweep - but I have been told they are like a very unpleasant internal - but you will get a few of those during labour anyway so perhaps one extra is not such a bad thing. I went in to hospital at 4 pm on a Monday afternoon, first dose of the drug (syntocinon I think) at 6 and things kicked off incredibly quickly with serious contractions before 11. I dont know what your hospital policy is but if you can get induced on the labour ward itself.  A number of my friends started their inductions on an ante-natal ward and contractions then stopped as soon as they moved down to the labour ward. I then had contractions through the night - I had diamorphine at about 2am to help me try and sleep - I didn't sleep but boy was it amazing stuff. I continued with strong contractions which were getting increasingly painful so at about 8am I succumbed to an ambulatory epidural. If you want one its important to get it before you get too dilated as there comes a point when they wont do it anymore.  All the way through to the birth I was able to be up and about, on my knees, on my back whatever I wanted. I did have quite a lot of time hooked up to the monitor but even when hooked up I could still get up and move around. 

My dd was finally born under her own steam at 2.17pm on the Tuesday.  I was moved up to the post natal ward around 5/6pm. 

Midwives' shifts will mean that you are almost certain to have a change of midwives. I had one when I started, she went home in the early evening (about 6.30 ish) and came back to me the next morning around 8.30 so I had someone else overnight. My primary midwife was supposed to be having a half day on the Tuesday but she stayed until DD was born so that I didn't have another change.

My understanding is that with induction you are more likely to get very strong contractions as soon as the drug starts to work unlike normal labour where there is more of a gradual build up which isn't quite such a shock and makes the pain easier to bear. I don't know about increased c-section risk but I know with my induced friends who did get c-sections theirs were due to the labour going on far too long because of the stop half way through when they were transferred from ward to ward resulting in an exausted mother and a baby going into distress.

Sorry to ramble but my induction was totally fine - I was able to follow my birth plan pretty much. I also think there is a difference between early imnductions anbd those done for overdue babies - my anecdotal experience suggests they are easier if early than late.

I will be thinking of you for tomorrow.
Love
Betty x


----------



## emmadaffodil

Thanks Betty,

It is so encouraging to hear a real-life story of how these things go. I have such a fear of the unknown, but perhaps I'll take it all in my stride once I get there. 

Emma, xxx


----------



## jan27

Emma,

Have the hospital not given you any written info?

When you are admitted for induction, (usually to antenatal ward)your cervix will be assessed to see how ripe it is.  If unripe, you will need prostin gel/pessary inserted by your cervix.  This helps to ripen the cervix by softening, shortening and opening the cervix.  You may need 2-3 doses at least 6 hours apart.  The prostin can make you contract but usually it is just a side effect and will go away again, however on occasions it can kick start labour and it will be allowed to continue. Labour does'nt stop!!  Diamporphine/pethidine is excellent for early labour/prostin pains, especially if tired and long haul..

If your cervix is fairly ripe, ie 2-3cm dialted and soft, the midwives may say you are suitable to have your waters broken.  You will usually be transferred to labour ward for this.  Breaking waters does not hurt, but it is a weird and wet sensation!  You may be given a couple of hours to see if you start contracting on your own, if not a syntocinon IV will be administered and baby will be monitored continuously throughout labour.
Labour started in this manner is usually more painful and many first timers end up with epidurals.

Inductions for post dates are generally easier and staright forward as cervix may be more favourable, however women do deliver earlier before their due date so some ripening may have already taken place.  C-section is increased with induction but not sure of rates however, at the end of the day, you are being induced for good medical reason, so you need to go with the flow.  A healthy mother ad baby is the outcome you want.

Hope this helps
Good kuck

jan


----------



## Betty M

Jan's post reminded me - see its true you do forget labour(!) - I only needed one lot of pessary and never needed the syntocinon drip but did get my waters broken by the midwife.
Betty


----------

