gestational proteinuria
Introduction
Introduction Pregnancy proteinuria: Generally speaking, the protein in normal urine is very small, no more than 7~10mg/24h, which can not be detected by ordinary urine routine examination. When the protein content in the urine reaches a certain value, the test result is positive. The urine with positive protein content is called proteinuria. Pregnancy excretion of such urine is called pregnancy proteinuria. In fetal urine, when the protein content in the urine increases, regular urine examination can be measured, called fetal proteinuria. If the urine protein content is 3.5g / 24h, it is called a large amount of proteinuria.
Cause
Cause
Women who develop edema, proteinuria, high blood pressure or two of them after 20 weeks of gestation are pregnancy-induced hypertension syndrome. This is a relatively easy complication of pregnant women (especially primiparas) during pregnancy, often affecting the health of pregnant women, can be life-threatening in severe cases, and is also one of the causes of fetal death.
Examine
an examination
Related inspection
Urinary immunoglobulin (Ig) NST test urine sediment urine sediment type urine routine
When the protein content in the urine increases, regular urine examination can be measured.
1. Physical examination: pay attention to edema and serous effusion. Skeletal joint examination, degree of anemia and examination of heart, liver and kidney signs. Fundus examination, normal nephritis, normal or mild vasospasm, chronic nephritis, fundus arteriosclerosis, hemorrhage, exudation, etc. Diabetic nephropathy often has diabetic fundus.
2. Laboratory examination: urine protein examination can be divided into qualitative, quantitative examination and special examination. 1), qualitative examination is best morning urine, morning urine is the most concentrated, and ex vivo proteinuria can be ruled out. Qualitative examination is only a screening test, not as an accurate indicator of urine protein content. 2), urine protein quantitative examination. 3), urine protein special examination commonly used urine protein electrophoresis examination, can distinguish between selective proteinuria and non-selective proteinuria. The appearance of proteinuria is unfavorable for the prognosis of the fetus. The earlier the proteinuria occurs, the worse the prognosis of the fetus.
Diagnosis
Differential diagnosis
How do the causes of proteinuria identify each other?
(a) acute glomerulonephritis
After streptococcal infection, edema, hypertension, hematuria, proteinuria, and tubular urine appear.
(two) chronic glomerulonephritis
Edema starts from the lower limbs and spreads from the bottom to the top. It has a long course of disease and is prone to recurrence. In the late stage, renal function damage often occurs, and hypertension is the earliest.
(c) pyelonephritis
Symptoms of systemic infection, low back pain, bladder irritation, and laboratory tests for pyuria.
(four) systemic lupus erythematosus
It belongs to autoimmune diseases, hair loss, facial butterfly erythema, oral ulcer, migratory arthritis, photoallergic, Raynaud's phenomenon, and multiple organ damage is most common in heart and kidney. Kidney damage accounts for the first place. Its proteinuria is generally more, and some patients appear in the form of nephrotic syndrome.
(5) Multiple myeloma
Older men have a good hair, anemia is heavy and not commensurate with kidney damage. The disease progresses rapidly and is easy to damage kidney function, bone destruction, bone pain, and pathological fracture. Its urine protein is spilled proteinuria.
(6) Others
Severe exercise, microalbuminuria, fever, proteinuria, heart failure, renal congestion, proteinuria, drug poisoning, proteinuria, due to a clear history and corresponding physical examination, general diagnosis is not difficult. When the protein content in the urine increases, regular urine examination can be measured. The appearance of proteinuria is unfavorable for the prognosis of the fetus. The earlier the proteinuria occurs, the worse the prognosis of the fetus.
