Wellness

Pregnancy, Pre-eclampsia, and Protein in the Urine

May 25, 2010

Pregnancy, Pre-eclampsia, and Protein in the Urine

Another week, another question from an email subscriber: I had eclampsia in July 2008, I would have loved a kidney consult! Can there be any long term consequences of protein in the urine in pregnancy?

Dr. Aaronson: Thank you so much for your question! I appreciate the fact that you value my opinion.

Pre-eclampsia refers to high blood pressure and protein spillage in the urine after 20 weeks of pregnancy in a woman who had a normal blood pressure prior to getting pregnant. When the preeclampsia gets bad enough, a person may have a seizure. When this occurs the woman is said to have eclampsia. Normally, delivery of the baby is the treatment of choice to protect both the mother and the infant.

Mothers are at risk for recurrence of pre-eclampsia/eclampsia during their next pregnancy. Those who were diagnosed early on in the pregnancy and were noted to have been in critical condition have a 25-65% risk of reoccurrence. OB-Gyn doctors will watch you very closely and try to help prevent a recurrence.

Unfortunately, women diagnosed with preeclampsia are at greater risk than their counterparts for heart disease and stroke and should be treated aggressively by their provider for any risks they might have. Also, these women have an increased risk of kidney disease, including the need for dialysis. You may want to find out how much protein you currently are spilling in your urine. That helps the doctor make decisions regarding your care.

My recommendation: make sure you see your doctor and focus on preventive care and goal rate attainment. If you note that you have a GFR of 60 or less, have residual protein in your urine, or have any concern regarding your kidney function, please feel free to make an appointment with a kidney specialist.

3 Comments
  1. Delissa

    I too couldn't urinate. Janice, could you shoot me a email? I almost died from PE and HELLP in 2009 and was only 20 weeks.

  2. David Papandreas

    I agree with Dr. Michael Aaronson, that preventive care is the best treatment for preeclampsia. With delivery as the only method of curing the disease or at least stopping the progression to eclampsia, prevention is truly the best option to having a healthy pregnancy. By focusing on prevention, the baby is able to stay developing in the womb. A parents focus should be shifted to how they can remain as healthy as possible for as long as possible to give their baby the greatest chance of survival in the harsh outside world. While looking for resources to help guide us as parents in coping with preeclampsia, we were unfortunately coming up empty handed. We could not find websites or books to help us understand what to expect and how to manage my wife's preeclampsia. That is when I came up with the concept behind A Mom and Dad's Guide to Preeclampsia. I wanted to provide real stories of how my wife and I managed her preeclampsia and how we focused on preventive care. We knew we had to keep our baby boy, Owen, developing as long as possible in the safety of his mother's tummy. All throughout the pregnancy we found ways of staying positive and laughing and enjoying life, even with preeclampsia. Even while she was on bed rest the entire last month of pregnancy, when things should have been most stressful, we remained grateful and happy. The book is being released 9 months after our son was born beautiful and healthy, even though he was a month early. To help prevent this disease in the future, I am donating 10% of all profits to fund preeclampsia research in hopes of finding ways of preventing this disease along with possible cures (besides delivery). We wish all the expectant parents coping with preeclampsia the best of luck and know that if we can do it, so can you.

  3. Janis

    I had a relatively uncomplicated pregnancy. The last month my blood pressure started to rise. At my 41 week appointment I was told by my practitioner to go to the hospital to be induced because she feared that I may be developing pre-eclampsia. I arrived at the hospital and started receiveing pitocin. My blood and urine was tested and it came back negative for pre-eclampsia. I was in labor with pitocin 19 hours during that time I was not retested for pre-eclampsia. During that time I started (in my opinion) showing symptoms of pre-eclampsia. I complained to my nurse that I was unable to urinate and I had uncontrolled shaking in my thighs (which I later found out was noted as a seizure by the nurse). I also complained that the blood pressure cuff that I was hooked up to didn't seem to be working properly. I insisted on a manual reading be preformed. After 19 hours when I was fully dialated I experience a life threatening seizure. I stopped breathing. I had an emergency c-section. My son was born not breathing. He had Hypoxic-Ischemic Encephalopathy and seizures. He was resuscitated and received head-cooling to prevent damage to his brain. I have no memory of the day my son was born but I am thankful that we are both alive. Pre-eclampsia and Eclampsia is a serious condition. I pray for the day that Doctors find a way to prevent it.

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