What is the most significant finding in a urinalysis for a patient with preeclampsia
OverviewPreeclampsia is development of high blood pressure, swelling or high levels of albumin in the urine between the 20th week of pregnancy and the end of the first week after delivery. Eclampsia is development of convulsive seizures or coma without other causes during that same time frame. Show
SymptomsSigns of preeclampsia in a pregnant woman include:
In its milder forms, it may appear as borderline high blood pressure, swelling or water retention that doesn't respond to treatment or albumin in the urine. Pregnant women who have blood pressure of 150/110, marked swelling or water retention and high levels of albumin in their urine may also experience disturbances in their sight or have pain in the abdomen. Their reflexes may be hypersensitive. Causes and Risk Factors It is not known what causes these conditions. Preeclampsia develops in about 5% of pregnant women. These women are usually having their first baby or had high blood pressure or vascular disease before they became pregnant. If preeclampsia isn't treated it may suddenly turn into eclampsia. Eclampsia can be fatal without treatment. One complication of preeclampsia is a condition where the placenta detaches too early from the wall of the uterus (abruptio placentae). DiagnosisIn addition to the symptoms, a doctor may order blood tests, an analysis of the urine and tests of liver function. He or she will also try to rule out unsuspected kidney disease. TreatmentThe goal of treatment is to protect the life and health of the mother. This usually assures that the baby survives, too. When a woman has early, mild preeclampsia, she will need strict bed rest. She should be seen by her doctor every two days. She needs to keep her salt intake at normal levels but drink more water. Staying in bed and lying on her left side will increase her need to urinate. This keeps her from becoming dehydrated and her blood from getting concentrated. If she doesn't immediately improve, she may need to go into the hospital. Once she has been admitted, she will be given a balanced salt solution intravenously. She may be given magnesium sulfate intravenously until her reflexes return to normal. This reduces the risk of seizures. At the same time, blood pressure usually goes down. Swelling should begin to go down, too. If the high blood pressure doesn't respond to the magnesium sulfate, other drugs may be tried to lower blood pressure. Both the mother and baby need constant monitoring. The patient should be observed for complications such as headaches, blurred vision, confusion, abdominal pain, vaginal bleeding or loss of fetal heart sounds. Some doctors may admit the patient directly to the intensive care unit for continuous monitoring of the mother and baby. An obstetrician should be involved in the management of the condition. At this point the goal of treatment becomes delivery of the baby. Any woman who has preeclampsia that doesn't respond to treatment should be stabilized and delivery accomplished, no matter how long the pregnancy has been. Mild preeclampsia may take six to eight hours to stabilize. About four to six weeks after the baby is delivered, the signs of preeclampsia should begin to go away. The patient will need to be watched as closely and as often after delivery as she was during labor. About one out of four cases of eclampsia happen during the first two to four days after delivery. Although she may need to stay in the hospital longer than a normal delivery would require, a woman usually recovers after delivery quickly. She should be seen by her doctor one to two weeks after the delivery. It may be necessary for her to take drugs to manage high blood pressure. © 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. OverviewWhat is preeclampsia?Preeclampsia is a serious blood pressure condition that develops during pregnancy. People with preeclampsia often have high blood pressure (hypertension) and high levels of protein in their urine (proteinuria). Preeclampsia typically develops after the 20th week of pregnancy. It can also affect other organs in the body and be dangerous for both the mom and her developing fetus. Because of these risks, preeclampsia needs to be treated by a healthcare provider. What happens when you have preeclampsia?When you have preeclampsia, your blood pressure is elevated (higher than 140/90 mmHg), and you may have high levels of protein in your urine. Preeclampsia puts stress on your heart and other organs and can cause serious complications. It can also affect the blood supply to your placenta, impair liver and kidney function or cause fluid to build up in your lungs. The protein in your urine is a sign of kidney dysfunction. How common is preeclampsia?Preeclampsia is a condition unique to pregnancy that complicates up to 8% of all deliveries worldwide. In the United States, it's the cause of about 15% of premature deliveries (delivery before 37 weeks of pregnancy). Who gets preeclampsia?Preeclampsia may be more common in first-time mothers. Healthcare providers are not entirely sure why some people develop preeclampsia. Some factors that may put you at a higher risk are:
Symptoms and CausesWhat are the symptoms?Many people with preeclampsia do not have any symptoms. For those that do, some of the first signs of preeclampsia are high blood pressure, protein in the urine and retaining water (this can cause weight gain and swelling). Other signs of preeclampsia include:
It's essential to share all of your pregnancy symptoms with your healthcare provider. Many people are unaware they have preeclampsia until their blood pressure and urine are checked at a prenatal appointment. Severe preeclampsia may include symptoms like:
If your preeclampsia is severe, you may be admitted to the hospital for closer observation or need to deliver your baby as soon as possible. Your healthcare provider may give you medications for high blood pressure or to help the fetus's lungs develop before delivery. What causes preeclampsia?No one is entirely sure. Preeclampsia is believed to come from a problem with the health of the placenta (the organ that develops in the uterus during pregnancy and is responsible for providing oxygen and nutrients to the fetus). The blood supply to the placenta might be decreased in preeclampsia, and this can lead to problems with both you and the fetus. Does stress cause preeclampsia?While stress may impact blood pressure, stress is not one of the direct causes of preeclampsia. While some stress is unavoidable during pregnancy, avoiding high-stress situations or learning to manage your stress is a good idea. What week of pregnancy does preeclampsia start?Preeclampsia typically occurs after 20 weeks of pregnancy, but it can come earlier. Most preeclampsia occurs at or near term (37 weeks gestation). Preeclampsia can also come after delivery (postpartum preeclampsia), which usually occurs between the first few days to one week after delivery. In rare cases, it begins weeks after delivery. Will preeclampsia affect my baby?Preeclampsia can cause preterm delivery (your baby needing delivered early). Premature babies are at increased risk for health complications like low birth weight and respiratory issues. Diagnosis and TestsHow is it diagnosed?Preeclampsia is often diagnosed during routine prenatal appointments when your healthcare provider checks your weight gain, blood pressure and urine. If preeclampsia is suspected, your healthcare provider may:
Preeclampsia can be categorized as mild or severe. You may be diagnosed with mild preeclampsia if you have high blood pressure plus high levels of protein in your urine. You are diagnosed with severe preeclampsia if you have symptoms of mild preeclampsia plus:
Management and TreatmentHow is preeclampsia treated?Your healthcare provider will advise you on the best way to treat preeclampsia. Treatment generally depends on how severe your preeclampsia is and how far along you are in pregnancy. If you're close to full term (37 weeks pregnant or greater), your baby will probably be delivered early. You can still have a vaginal delivery, but sometimes a Cesarean delivery (C-section) is recommended. Your healthcare provider may give you medication to help the fetus's lungs develop and manage your blood pressure until the baby can be delivered. Sometimes it is safer to deliver the baby early than to risk prolonging the pregnancy. When preeclampsia develops earlier in pregnancy, you'll be monitored closely in an effort to prolong the pregnancy and allow for the fetus to grow and develop. You'll have more prenatal appointments, including ultrasounds, urine tests and blood draws. You may be asked to check your blood pressure at home. If you are diagnosed with severe preeclampsia, you could remain in the hospital until you deliver your baby. If the preeclampsia worsens or becomes more severe, your baby will need to be delivered. During labor and following delivery, people with preeclampsia are often given magnesium intravenously (directly into the vein) to prevent the development of eclampsia (seizures from preeclampsia). Is there a cure for preeclampsia?No, there isn't a cure for preeclampsia. Preeclampsia can only be cured with delivery. Your healthcare provider will still want to monitor you for several weeks after delivery to make sure your symptoms go away. PreventionHow can I reduce my risk of getting preeclampsia?For people with risk factors, there are some steps that can be taken prior to and during pregnancy to lower the chance of developing preeclampsia. These steps can include:
Can you prevent preeclampsia?Taking a baby aspirin daily has been demonstrated to decrease your risk of developing preeclampsia by approximately 15%. If you have risk factors for preeclampsia, your healthcare provider may recommend starting aspirin in early pregnancy (by 12 weeks gestation). Outlook / PrognosisWhat are the most common complications of preeclampsia?If left untreated, preeclampsia can be potentially fatal to both you and the fetus. Before delivery, the most common complications are preterm birth, low birth weight or placental abruption. Preeclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). This happens when preeclampsia damages your liver and red blood cells and interferes with blood clotting. Other signs of HELLP syndrome are blurry vision, chest pain, headaches and nosebleeds. After you've delivered your baby, you may be at an increased risk for:
Does preeclampsia go away after delivery?Preeclampsia typically goes away within days to weeks following delivery. Sometimes, your blood pressure can remain high for a few weeks after delivery, requiring treatment with medication. Your healthcare provider will work with you after your pregnancy to manage your blood pressure. People with preeclampsia — particularly those who develop the condition early in pregnancy — are at greater risk for high blood pressure (hypertension) and heart disease later in life. Knowing this information, those individuals can work with their primary care provider to take steps to reduce these risks. Living WithWhen should I see my healthcare provider?Preeclampsia can be a fatal condition during pregnancy. If you're being treated for this condition, make sure to see your healthcare provider for all of your appointments and blood or urine tests. Contact your obstetrician if you have any concerns or questions about your symptoms. Go to the nearest hospital if you're pregnant and experience the following:
What questions should I ask my doctor?If your healthcare provider has diagnosed you with preeclampsia, it's normal to have concerns. Some common questions to ask your healthcare provider are:
Frequently Asked QuestionsWhat's the difference between preeclampsia and eclampsia?Eclampsia is severe preeclampsia that causes seizures. It's considered a complication of preeclampsia, but it can happen without signs of preeclampsia. In rare cases, it can lead to coma, stroke or death. What is postpartum preeclampsia?Postpartum preeclampsia is when you develop preeclampsia after your baby is born. It typically happens within two days of giving birth but can also develop several weeks later. The signs of postpartum preeclampsia are similar to preeclampsia and include swelling in your limbs and extremities, headaches, seeing spots, stomach pains and nausea. It's a serious condition that can cause seizures, stroke and organ damage. A note from Cleveland Clinic Preeclampsia is a serious condition that you may not be aware you even have. It's important to go to all your prenatal appointments and be open about all the symptoms you feel during pregnancy. When preeclampsia is caught early, it can be treated and managed to keep both you and the fetus safe and healthy. Most people with preeclampsia go on to have healthy babies. What is found in urine with preeclampsia?With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage.
Which laboratory finding in a client's urinalysis report indicates preeclampsia?Laboratory values for preeclampsia and HELLP syndrome
Proteinuria level above 300 mg/24 hours. Urine dipstick over 1+ Protein/creatinine ratio greater than 0.3. Serum uric acid level above 5.6 mg/dL.
What lab values indicate preeclampsia?Preeclampsia: Lab abnormalities. Proteinuria of: >300 mg/24 h (mild preeclampsia) >5 g/24 h (severe preeclampsia) Urine dipstick >1+. Protein/creatinine ratio >0.3.. Serum uric acid >5.6 mg/dL.. Serum creatinine >1.2 mg/dL.. Low platelets/coagulopathy.. Platelet count <100,000/mm3.. Elevated PT or aPTT.. Decreased fibrinogen.. What change in urine is an indicator of pre eclampsia?Proteinuria generally increases as preeclampsia progresses, but increased urinary protein excretion may be a late finding [120,121]. It usually remains <5 g/day, but levels >10 g/day may be seen. Preeclampsia is the most common cause of severe proteinuria in pregnancy.
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