In plain words
Proteinuria means there is protein in the urine. Healthy kidneys keep most protein in the blood. When the kidney's filters leak, protein passes into the urine. In pregnancy, a small amount can happen for harmless reasons, but more protein can be a sign of . Providers check urine protein at visits, often with a dipstick and sometimes with a lab test over a day. A positive test does not mean you have preeclampsia by itself. It is one sign among others, including blood pressure, blood tests, and symptoms. If you are asked to collect urine over a day or to come back for a recheck, that is a routine step that helps your provider see the full picture.
The deeper version
Proteinuria in pregnancy is assessed by dipstick, spot protein-to-creatinine ratio, or 24-hour collection, with thresholds used in ACOG Practice Bulletin 222 (2020) for the diagnosis of preeclampsia. Pregnancy normally increases glomerular filtration, and modest proteinuria can be physiologic. In preeclampsia, driven by antiangiogenic factors, including and soluble endoglin, increases glomerular capillary permeability, and proteinuria further lowers plasma oncotic pressure, contributing to edema. Proteinuria can persist postpartum, and its trajectory informs prognosis for chronic kidney disease. The main controversy concerns whether proteinuria is required for diagnosis, given that preeclampsia may present with end-organ features without it.
Where it comes up
- High blood pressure and preeclampsiaPregnancy: Your Body
- Postpartum preeclampsia: the warning signsPostpartum: Your Body
- Swelling: feet, ankles, hands, facePregnancy: Your Body
- Headaches and migrainesPregnancy: Your Body
What mothers here say about proteinuria
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 222: Gestational Hypertension and Preeclampsia (2020)
- Brown MA et al. — The hypertensive disorders of pregnancy: ISSHP classification, diagnosis and management recommendations for international practice. Pregnancy Hypertension (2018)