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Was given hyper stimulation during treatment. Has high traces of albumin in urine. Home remedy?

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hi, Me and my wife went for an ICSCI treatment to get pregnent and by the grace of GOD we are into 18th week of our "twin" pregnency. She was given OHSS (hyper stimulation) during the treatment. A Cervix cerclage was also been applied on 7th Jan'2012. After which she has been advised complete bed rest. The issue that we are facing now is she is having high traces of albumin in her urine, the 24 hr urine test shows about 4.2g of protien out of 2750 ml of total urine sample. Her TLC reading is 0000. The LFT, RFT blood test shows the albumin reading of 3.4.
Our IVF doctor has now refered us to nephrologist. My wife is currently taking duphaston (morning and evening), Fol 1-2-3 and Iron and Calcium tablets and a weekly progestrone injection (discontinued from today). Can you please suggest a safest home remedy or safe medicine that we can take during this stage in pregnency.
Posted Tue, 8 May 2012 in Kidney Conditions
Answered by Dr. Avinash Ignatius 4 hours later

Thank you for the query.

Your wife is having Nephrotic range proteinuria. This could be either related to the pregnancy or an independent kidney disease. I would need some more details, before considering possibilities further.
Has her blood pressure increased recently. What is her serum creatinine and Uric acid levels. Has ANA/ANCA test been done.
If no further problem arises, proteinuria can be followed up post delivery. A biopsy may be needed if her proteinuria persists, after delivery. Only very few centres do a biopsy before delivery.
As of now other than increasing her protein intake to compensate for the losses, no other treatment is advisable.A close watch needs to be kept on her BP - at least weekly or more frequently.

Hope I have answered your query. Please do get back to me if you have any further queries.

Wishing your wife a safe pregnancy.

Above answer was peer-reviewed by
Follow-up: Was given hyper stimulation during treatment. Has high traces of albumin in urine. Home remedy? 13 hours later
Thank you for your reply Doctor.
To answer your questions. Yes her Blood pressure has increased, and we are monitoring it twice daily its usually in the range of 130 to 137(upper) and 70 to 98(lower).
Creatinine is 1.0
Uric Acid is 4.0.
No, the ANA/ANCA test has not been done yet.

Also if we increase her protien intake, won't that put more stress on the kidneys?
What sort of complications are we looking at if this persists.

Answered by Dr. Avinash Ignatius 1 hour later
Thanks for reverting.
It is likely that she has pre-eclampsia, a condition characterised by hypertension during pregnancy (although, the onset of this condition usually the onset is after 20 weeks). However, it can occur earlier as it is a twin pregnancy. Pre-eclampsia is a condition which will automatically go away once she delivers her children. The other possibility is that she had an independent problem before pregnancy (but it can be ruled out if the previous urine reports are normal)
Pregnancy is a very special situation. Her protein intake needs to be adequate as she is losing protein, (We) and she has two developing babies inside who need adequate nourishment. In an analogous situation, we don't ask someone to not drink water, when they have diarrhoea
If her blood pressure (BP) remains stable, she would only need monitoring. If BP rises, she needs to be put on medications. Effective medication for the control of high blood pressure exists and is widely used.
Very rarely, a situation arises where BP becomes uncontrolled and it can be life threatening with risk of seizures. At that time, delivery needs to be done earlier to avoid undue risk to mother.
I hope I have answered your query.
Above answer was peer-reviewed by
Follow-up: Was given hyper stimulation during treatment. Has high traces of albumin in urine. Home remedy? 1 hour later
Thanks so much for replying back Doctor.

To answer your question, her earleir urine tests had a few "traces" of albumin and also she does not have any prior history of high BP.

Should our main concern be to get her BP under control?
If yes, then what could be the possible home remedes/precautions to control BP.
If no, then what are the other areas we should be concerned about?

What can be the impact of pre-eclampsia on our pregnancy and mother's health?

What are the chances that our pregnancy can be continued till 36th week along with pre-eclampsia as it is still at 18th week so that even if an early delivery is required, it can be done after 36th week.

Answered by Dr. Avinash Ignatius 7 hours later

Thank you for writing back.

She is likely to be having preeclampsia.

There are no specific remedies, except keeping a close watch on the blood pressure and adequate rest.

Unlike in other conditions with blood pressure do not restrict salt, but keep intake normal.

Even at 32 weeks of pregnancy, delivery can be attempted at a good centre if need arises.

Get a Nephrologist involved in her management. Aim is to continue pergnancy as long as possible without undue risk to the mother.

There is no way to predict the exact course of the condition except keeping close watch and manage the high blood pressure promptly and adequately.

Hope My answer has been of some help. Do write back if you have any further queries.

Please accept my answer if you no more concerns.

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