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Higher levels of albumin in urine during pregnancy. Did ultrasound scanning. What are the precautionary measures need to be taken?

My wife is in the 36th week of pregnancy.Her due date is 26th April.She had her check up done today.Higher levels of albumin was found in her urine.The ultrasound/scanning done showed that baby is fine with current weight as 2.95 kg.Please advise on what immediate precuationary measures need to be taken.The reports are yet to be see by the consulting doctor.
Asked On : Mon, 8 Apr 2013
Answers:  2 Views:  34
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General & Family Physician 's  Response
Hi and thanks for the query,
the commonest concern in pregnancy associated with high albumin levels is pregnancy induced hypertension or pre eclampsia. It is important for her blood pressure to be taken to see whether it is raised with respect to the baseline. Other signs like pedal oedema frequent headaches, abdominal pain especially epigatsric and visual difficulties at times could be suggestive of pre eclampsia.
However, in case these findings are all negative, kidney function tests and a urine culture should be done to exclude both kidney disease and a urinary infection.
It ultimate for her to get consulted by her physician to know her blood pressure levels, any family history of high blood pressure in previous pregnancies and the above cited clinical signs.
Thanks and hope this helps,
Luchuo, MD.
Answered: Mon, 8 Apr 2013
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General & Family Physician Dr. Nirmala P's  Response
Hi, thanks for asking in Healthcare Magic.

Kidney blood flow and filtration rate of kidney are increased in normal pregnancy. In late pregnancy urine flow and sodium excretion depends upon the posture, more when the person lies on on one side and less when she lies on back.

Protein is not normally excreted in urine during pregnancy. The pathological (abnormal) changes in kidney result in reduced filtration rate, reduced renal blood flow and excretion of protein (proteinuria/albuminuria).

Higher levels of albumin in urine indicates that your wife is having Preeclampsia. Preeclampsia is characterised by pedal edema (swelling of feet and ankle), high BP, and proteinuria. If proteinuria is more than 0.3g/l then it is significant.

Preeclampsia may be mild or severe. In severe type there may be headache, vomiting dimness of vision and stomach pain along with high BP. If your wife's BP is above 140/90 along with albuminuria (high levels of albumin in urine), then the following investigations need to be done.
1. urine examination for casts, estimation of blood urea, uric acid and creatinine, platelet count.
2. liver function tests.
3. fundus (eye) examination.

Proper rest (lying on left side improves blood supply to uterus) is necessary. salt restriction may not be needed. If BP is high then it needs to be controlled by drugs like diuretics and anti hypertensive drugs.

I hope this is useful to you.
Answered: Mon, 8 Apr 2013
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