A change occurring in a pregnant woman that is indicative of a potential disorder is increased urinary protein, pregnancy induced hypertension is characterized by a rapid rise in arterial blood pressure with loss of large ants of protein in the urine.
What is the clinical significance of proteinuria in pregnancy?
- Urinary protein excretion is taken into account abnormal in pregnant women when it exceeds 300 mg/24 hours at anytime during gestation.
- If Proteinuria is documented before pregnancy or before 20 weeks' gestation suggests preexisting renal disease.
- The National High vital sign Education Program Working Group recommended that that the diagnosis of proteinuria be based on the 24-hour urine collection.
- Preeclampsia is that the leading diagnosis that must be excluded in all women with proteinuria first identified after 20 weeks of gestation.
- Given the vasospastic nature of this condition, when it's present, the degree of proteinuria may fluctuate widely from hour-to-hour. Hypertension or proteinuria could also be absent in 10-15% of patients with HELLP syndrome and in 38% of patients with eclampsia.
- The acute onset of proteinuria and worsening hypertension in women with chronic hypertension is implicational superimposed preeclampsia, which increases adverse outcomes.
- However, because proteinuria isn't independently predictive of adverse outcome, an exclusive proteinuria criterion as a sign for preterm delivery in preeclampsia should be discouraged.
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