General urine test during pregnancy and its interpretation

During the anxious period of pregnancy, most organs and systems of the female body are amenable to global restructuring. Kidneys occupy one of the first places in this process. During pregnancy, there is an increase in kidney size by 2 cm, dilation of the ureters, increased renal blood flow and physiological hydronephrosis. This directly affects urine levels during pregnancy. Therefore, you need to know what to be wary of and what deviations in indicators are considered physiological characteristics during pregnancy.

What it is?

Urine is a biological fluid, a waste product of all living things, which consists of 97% water, and the remaining percentage consists of salts and products of nitrogenous origin. Together with urine, waste and toxins are removed from the body.

Attention! The informative ph indicator indicates the acidity of the urinary fluid and how many hydrogen ions are in a person’s urine, which can be seen in the studies carried out. The genitourinary system provides the process of filtration, absorption, and release of toxins.

When taking a urine test, you can see the level of acidity in the answers, i.e. pH of urine.

What is it? Urine pH (normal 4-8 units) is the result of metabolic processes that primarily occur in the kidneys, lungs, and liver.

The state of human health is determined directly by the pH of urine.

You can determine it by passing tests or tests:

• The consumption of protein foods with vitamin C leads to a decrease in the acidity of urine.
• Eating vegetables increases the pH of urinary fluid.

For analysis, urine should be collected only in the morning. It is necessary to prepare clean, dry dishes in advance (you can purchase ready-made containers at the pharmacy) and wash your genitals.

If urine is collected in the evening, then leukocytes, red blood cells, and epithelial cells may begin to break down overnight, which will not give the correct result. A portion of the urethra is taken randomly.

What is the pH of urine and what does a deviation from the norm indicate? is explained in the video:

How to correctly collect material for a general urine test during pregnancy?

In order for laboratory results to be reliable, you need to properly prepare for urine collection. Often women neglect basic recommendations and as a result they end up with bad tests.

Rules for collecting urine for clinical analysis:

1. 24 hours before diagnosis, exclude coloring foods from your diet (vitamins, beets, blueberries, tomato juice), as this may make it difficult to determine the “color” of urine. In addition, avoid fried and pickled foods.
2. Avoid physical activity and sexual intercourse 10-18 hours before taking the sample to prevent overdiagnosis. They promote the appearance of protein in the urine.
3. If your health allows, doctors advise skipping one dose of a diuretic before taking a urine test.
4. To collect urine, buy a special container from the pharmacy. It is sterile and closes tightly. You can take a homemade glass jar and sterilize it yourself, but this is not very convenient and often leads to repeated analysis. Don't forget to include your details on the urine containers.
5. A special place is occupied by hygiene of the genital organs. Immediately after waking up, you need to take a shower or wash yourself thoroughly. Women in late pregnancy experience vaginal discharge. If they are abundant, then use a gauze pad to prevent them from getting into the urine.
6. For a general analysis, an “average portion” of morning urine is taken in a volume of 100-150 ml. How to do this: flush the first portion of urine into the toilet for two seconds, then the main part into the container and the rest of the urine back into the toilet.
7. The container with urine should not be shaken and should not be stored for a long time. The optimal delivery time to the laboratory assistant is 1.5-2 hours.

What should the acidity be?

The average pH value of the urinary fluid of an adult in the morning is 6.0-6.4 units, and if the sample was taken in the evening - 6.4-7.0 units.

The ph level of urinary fluid is 4-8 units, depending on many aspects:

• patient's age,
• food products,
• consumed the day before
• time of sampling.

In children, the pH values ​​of urinary fluid are completely different:

• If the mother feeds the baby with breast milk, then the norm is 6.9-7.8 units,
• if he is bottle-fed, then the figure can reach 5.4-6.9 units.

The acidity level of an adult is reached only by age 12.

Normal indicators of general clinical analysis

Below are characteristics and numbers that are typical for tests of healthy women.

How could this be dangerous?

If the pH of the urinary fluid does not adhere to the normal range, then fine sand may subsequently be found in the kidneys.

If an increased or decreased pH of urine is observed for a long time, then grains of sand can form phosphate, urate or oxalate stones in the kidneys. Stones can lead to various complications in the body.

With an increased pH of the urinary fluid, the following complications arise:

1. Toxins and metabolic products are poorly excreted, which leads to metabolic disorders and metabolic processes.
2. The proliferation of bacteria and infectious agents in the body, which leads to an inflammatory process in the bladder or kidneys.
3. Disruption of the cardiovascular system due to increased blood viscosity, formation of blood clots.

If the pH value of urine is low, the patient must undergo examination to confirm/refute diseases such as pyelonephritis, cystitis, hypokalemia, and the presence of E. coli in the bladder.

Is it possible to determine on your own that urine does not indicate problems?

You can determine the signs of “good” urine using your own observations if you pay attention to the following factors:

• Color of collected urine . Normally, its shade should vary from straw yellow to amber yellow. The color can be enhanced by taking multivitamin medications prescribed to expectant mothers. However, the shade should in no case be dark.
• Smell . It may not exist at all, or it may not be pronounced. No strong aromas. If you feel some acidity and the smell is intrusive, you should inform your doctor.
• Transparency . Urine should be clear, there can be no talk of any cloudy impurities. If the collected liquid is cloudy, that is, it is impossible to see anything else through the container, most likely there are bacteria and epithelium in large quantities in the urine, which is not a good sign.

Causes of high acidity

The reasons for increased ph levels of urinary fluid can be different:

1. Eating behavior. A person often eats foods containing protein or fat. For example, these are eggs, meat or sausages, homemade dairy products.
2. Prolonged fasting. When following strict diets, there is a lack of carbohydrates and an increased process of breakdown of protein and fat reserves necessary for the production of energy in the body.
3. Physical exercise. When performing hard work that requires physical effort or playing sports, the body is overloaded for a long time, which causes dehydration. Working in a hot shop, being in a stuffy room, hot climate conditions also causes dehydration.
4. Diseases of the urinary system . In inflammatory processes caused by E. coli or tuberculosis, there is insufficient production of adrenal hormones, the presence of blood in the urine, cystitis, pyelonephritis, hyperkalemia, renal tuberculosis, and renal tubular acidosis may occur.
5. Elevated sugar levels, diabetes.
6. Alcohol, etc..

Properties of urine

Metabolic products are released through urine. Its formation occurs in nephrons at the time of filtration of plasma and blood. Urine includes 97% water, the remaining 3% is salts and nitrogenous substances.

The required pH of body fluids is maintained by the kidneys by removing unnecessary substances and retaining elements involved in important metabolic processes.

The excreted substances have acid-base characteristics. When there are a large number of acidic particles, acidic urine is formed (pH level drops below 5). The pH value of urine is slightly acidic (5–7). If alkaline properties predominate, alkaline urine is formed (pH about 8). If the indicator is 7, this is a balance of alkaline and acidic substances in urine (neutral environment).

What does acidic or alkaline balance mean? It indicates the degree of efficiency of the process of processing minerals responsible for the level of acidity. In a situation where the urine pH value is exceeded, the acid is neutralized due to the minerals found in the bones and organs. This means that the diet is dominated by meat products and lacks vegetables.

Why was it lowered?

An alkaline reaction of urinary fluid can be caused by various reasons. For example, the diet has changed dramatically, during which acidity regulation fails.

The alkaline balance of urine may be low for the following reasons:

• infection detected in the genitourinary system;
• various diseases of the gastrointestinal tract, adrenal glands, thyroid gland;
• the baby suffers from rickets;
• prolonged vomiting;
• eating only products of plant origin, alkaline mineral water;
• postoperative period.

When the pH of the urinary fluid is low, a person experiences a pressing headache, weakness, and nausea.

Laboratory tests of urine during pregnancy

A urine test during gestation is prescribed to prevent deterioration of well-being and the development of hidden pathological processes. High-quality diagnostics, carried out in any institution or network of Invitro laboratories, allows you to promptly identify and eliminate the symptoms of an incipient disease.

During the period of gestation, a woman’s urinary system begins to function more intensively, trying to evacuate metabolic products not only from the mother, but also from the child in the womb. In the early stages, due to an increase in the speed of blood flow, the organs receive it in a larger volume than usual. As a result, glomerular filtration increases, while tubular reabsorption remains at the same level. This leads to the development of swelling.

Simultaneously with the increase in pregnancy and fetal growth, the uterus increases in size. It compresses neighboring organs, impairing their functioning, causing them to strive to change their location. The bladder moves upward, leaving the pelvic area; in some cases, a hydroureter develops, in which the lumen of the excretory tract expands. This becomes a favorable circumstance for the penetration of various kinds of infections along the ascending path into the bladder and further into the kidneys.

Purpose of appointment and frequency of administration

Urine examination is an important prognostic parameter for the condition of the kidneys and the entire urinary system. It does not require effort on the part of the expectant mother, but provides valuable information for the doctor, allowing you to adjust pregnancy management tactics.

Advice! Urinalysis makes it possible to promptly detect inflammatory diseases such as cystitis, pyelonephritis, as well as some dangerous conditions - gestosis, diabetes mellitus, preeclampsia.

Changes in the levels of protein, glucose, and leukocytes may indicate the presence of pathologies that are not always caused by impaired renal function. During the gestation period, the urinary organs react to changes in the functioning of the immune, cardiovascular, and endocrine systems. This is why laboratory testing is often carried out for monitoring purposes. In most cases, pregnant women are prescribed a general urine test. It pursues the following goals:

• dynamic monitoring of the pregnant woman’s well-being;
• early diagnosis of pathologies of the urinary system and other internal organs;
• monitoring the course of the identified disease;
• assessment of the effectiveness of the chosen therapy.

The frequency of clinical analysis is:

The state of urine as an important diagnostic sign

Considering the data indicated in the table, the woman actually has to get tested at every scheduled visit to the gynecologist.

Urine is an ultrafiltrate of blood plasma, a human waste product, and is an aqueous solution of electrolytes and organic substances. Its composition is quite complex and includes many components of various origins, which should normally be excreted from the body.

One of the main functions of the kidneys is to filter blood plasma and cleanse it of substances unnecessary for the body - ballast. The method of their penetration into urine is different - some are secreted through the glomerular apparatus, others are secreted through the renal tubules. All these elements enter the liquid, forming primary urine. During the process of reabsorption (reabsorption), they re-enter the blood, after which a secondary product is formed. It is excreted by the kidneys into the bladder, and then out through the urethral canal.

Types of analyzes and their characteristics

The study of urine during pregnancy can be performed using various methods. First of all, to confirm conception, it is recommended to conduct a pregnancy test - a urine test at home. In medical practice, there are a number of tests; the selection of the most informative in each specific situation is made by the doctor. General clinical analysis is routine. It is considered a screening test, and if unsatisfactory results are obtained, the doctor prescribes a more detailed extended diagnosis. This includes a biochemical study that allows one to detect the concentration of complex compounds, as well as various tests that make it possible to determine pathological changes occurring in the body.

General clinical urine analysis

It is the most informative and popular type of urine test in medical practice. Prescribed to all pregnant women from the moment of registration at the antenatal clinic. It involves a thorough study of organoleptic, physicochemical, biological properties, as well as microscopic examination of the sediment. If the values ​​of the main indicators correspond to the norm, then the pregnancy proceeds normally, and there are no deviations in the functioning of organs and systems.

Urinalysis according to Nechiporenko

This type of study is carried out to identify infectious lesions of the genitourinary system, to check the functional capacity of the kidneys, urethra, and bladder during pregnancy. It allows you to determine the number of formed elements in 1 ml, taken per unit volume. The following values ​​are considered normal:

• leukocytes – up to 2000;
• red blood cells – up to 1000;
• cylinders - up to 20.

Attention! The Nechiporenko test is prescribed during monitoring of gestation, in case of unsatisfactory results after OAM. The purpose of the analysis is to give a more complete clinical picture of the changes occurring in the body of the expectant mother.

Zimnitsky test

The purpose of diagnosis is to assess the concentration and throughput function of the kidneys. The study reveals daily diuresis, that is, how many liters of fluid can pass through a paired organ in 24 hours, as well as how the dilution function is performed (if secondary urine contains a large number of components useful for the body, it is considered unsatisfactory).

Urine collection is carried out throughout the day according to a special scheme: one portion of liquid is placed in each container (6-8 in total). The interval between receiving them is on average 3-4 hours.

Rehberg's test

It is carried out to assess the reabsorption and excretory function of the kidneys and glomerular filtration rate. The indicator is the renal clearance of endogenous creatinine. This type of analysis is indicated when it comes to nephritis, renal failure, “shrinked kidney” syndrome, glomerulonephritis.

The material should be collected throughout the day, noting the number of acts of urination and the volume of urine released at a time. The biological material prepared in this way must be mixed and poured into a 50-70 ml container.

LHC urine culture

During a general clinical analysis, the laboratory technician is required to conduct a microscopic examination of the sediment. If fungi or other microorganisms are detected in it in concentrations exceeding normal values, the development of bacteriuria is indicated, and a more in-depth study of the condition is carried out, determining the type of microorganisms. During the gestation period, this analysis is indicated twice: at 9-12 and 35-36 weeks. If an infection is detected, the examination is carried out more often. Material for culture should be collected using a catheter. To avoid pain, it must be inserted by a nurse.

Important indicators and their normal values

When a urine test is performed during pregnancy, expectant mothers are interested in what it shows. Women want to get a transcript and find out if there are any abnormalities in the functioning of the internal organs. It should be understood that only a doctor can provide a qualified opinion, while the patient can only approximately interpret possible deviations, relying on reliable sources of information.

Mandatory parameters for urine analysis during pregnancy are considered to be the normal values ​​indicated in the table. These are available in various reference materials. These data are typical for a healthy girl or woman before conception.

The results of the analysis during the gestation period should also not differ from the norm. Despite the excessive stress that the excretory system experiences during pregnancy, compensatory functions smooth out these changes without going beyond physiology. The appearance of any, even minor, deviations indicates hidden or obvious pathologies. You need to know a little more about them, even in general terms.

The most common deviations and their causes

The most important step in making a correct diagnosis based on a urine test in pregnant women is considered to be a competent decoding of indicators and determination of the norm. The effectiveness of the prescribed treatment and the adequate choice of medications depend on a clear and reliable identification of the cause of existing deviations. To gain an in-depth understanding of the processes occurring in a pregnant woman’s body, it is not enough to know about normal indicators. It is important to have an idea about the main pathological changes that can await a woman during pregnancy. These include:

• changes in color and density;
• decreased transparency;
• proteinuria – high protein;
• glucose;
• presence of erythrocytes and leukocytes;
• bacteriuria.

The intensity of the deviations depends on the type of pathology and the degree of its severity, and here we are talking not only about disorders of the genitourinary area, but also diseases of other organs.

Amount of urine. In medicine, it is called diuresis and refers to the volume of urine excreted in a certain unit of time - day, night, day. In normal conditions, it makes up 70-80% of the liquid drunk with a consumption rate of 1.5-2 liters. In a pregnant woman, this parameter increases by a quarter, which is due to the intensive functioning of the kidneys.

Color. Light, transparent urine indicates a low concentration of substances and is typical for diabetes of any type. On the contrary, brightly colored urine is released when there is intense loss of fluid from the body (fever, vomiting, diarrhea). A reddish-brown tint indicates possible kidney injuries and tumor processes.

Transparency. Turbid urine indicates inflammatory diseases of the genitourinary tract or changes in protein, fat, mucus, salts, red blood cells or bacteria. To clarify the cause, additional studies are performed.

Density. High levels indicate dehydration, which can develop as a result of conditions such as diabetes mellitus, toxicosis or glomerulonephritis. Hypersthenuria is observed in kidney pathologies and preeclampsia.

Urine reaction. A low reading indicates the presence of fever, tuberculosis or diabetes. High values ​​are observed in inflammatory diseases.

Protein. An increased amount is typical for infectious lesions of the genitourinary system, severe toxicosis, preeclamptic syndrome, and renal pathologies.

Glucose. During pregnancy, the level of the substance fluctuates in the range of 3.2-5.4 mmol/l. values ​​below or above the specified threshold indicate hypo or hyperglycemia. In later stages, such deviations indicate the appearance of gestational diabetes.

Bilirubin. If it is present in urine in any quantity, you should pay attention to the liver, since problems with this organ provoke the release of urobilin.

Ketone bodies. In addition to glucose, acetone is considered a characteristic indicator of the likelihood of developing diabetes. Normally, they should not be present in a pregnant woman.

Red blood cells and leukocytes. If they are detected, doctors suspect the presence of internal bleeding or severe inflammation. During the gestation period, the presence of 1-2 units in the field of view is considered normal.

Epithelium. The acceptable value for the presence of the internal lining of the body cavity in urine is 0-3 cells. Exceeding this indicator indicates inflammation of various etiologies.

Salt. Phosphates, urates or oxalates may be detected in the urine of a pregnant woman. Regardless of the type, they are a sign of metabolic disorders or nutritional errors.

Ways to reduce and increase acidity levels

Normalization of indicators is facilitated by changes in the daily diet, the use of medications that correct dysfunction of internal organs, and the elimination of cholesterol-rich foods, food additives, and dyes from the diet.

When urine is acidified, a diet of neutral and negative acidic foods is prescribed according to the PRAL scale (calculation of the potential acid load of the kidneys).

According to medical studies, when a tendency to alkaduria appears, it is necessary to reduce the consumption of protein-containing foods, increase the amount of vegetables and fruits eaten per day, and prefer a drinking regime that includes mineralized water without carbonation, containing molecules of potassium and magnesium.

Recommended to eat:

• Products having zero PRAL:
• milk products;

• butter, vegetable fat;
• cucumbers;
• ice cream;
• tea;
• honey.
• Negative acidity on the PRAL scale:
• greenery;
• fruit and vegetable nectars;
• vegetables;
• mushrooms;
• fruits;
• red and white wines;
• mineralized water;
• coffee.

Negative acid food table:

Low-acid products include bread made from first-grade and second-grade flour - 3-12.

In addition to diet, you need:

• Stop overstraining the body with increased physiological stress. It is best to switch to gentle sports (running, swimming, athletics, cardio equipment).

• Stop taking diuretics.
• Do not get carried away with ascorbic acid, prefer other means to boost immunity.
• Eliminate cholesterol-rich foods, food additives, dyes, and industrially produced sweets from your diet.
• If values ​​characteristic of aciduria persist for more than 2 weeks, you should consult a doctor and undergo a full medical examination.

When alkalizing it is recommended:

• Drink water with lemon juice, lime, and apple cider vinegar on an empty stomach every day.
• Persons suffering from hypertension should add 1⁄4 tsp to their drink. baking soda.
• Remove desserts, sugar, artificial sweeteners, and carbonated lemonade from your diet.
• Do not indulge in fatty meat products. Protein can be obtained from poultry, lean fish, soy, cheese, and tofu.
• Avoid consumption of cholesterol-rich foods, canned fish and meat, smoked delicacies, sausages, sausages.
• Include low-fat fermented milk products and cottage cheese in your diet.
• Avoid stressful situations.
• Engage in moderate physiological activity, giving preference to running, swimming, and dancing.
• Do not exceed the norms of fluid intake, eliminate Coca-Cola, Sprite, Mirinda from the diet. The listed drinks help remove calcium from the body.
• Take a course of vitamins and minerals.
• Check the pH value at least once every 3-4 days. If indications characteristic of alkaluria persist, a doctor’s consultation, a detailed examination of the body, and correction of identified internal pathologies are required.

A diet to normalize acidity levels should consist of 80% alkali-forming and 20% acid-forming foods.

For the treatment of dysfunctions of internal organs and systems, normalizing the pH level in urine is of great medical importance. If decreased or increased values ​​are detected in a timely manner, additional laboratory testing and medical and nutritional adjustments are carried out.

Article design: Oleg Lozinsky

Test according to Nechiporenko

The doctor directs women to take the Nechiporenko test as an additional study to a general urine test if, when deciphering its results, a deviation in the indicators of leukocytes, red blood cells or cylinders is detected. Formed elements are determined in urine sediment using microscopic examination per 1 ml. A large number of pathologies of the genitourinary organs can be confirmed or excluded when deciphering the results of the Nechiporenko test.

Collecting material for research using the Nechiporenko method requires compliance with certain rules, otherwise false results may be obtained and an erroneous diagnosis will be made. You cannot donate urine during menstruation, or several days before and after it. It is not recommended to perform a test with a catheter inserted. Before collecting the material, you need to thoroughly wash your genitals and insert a cotton swab into the vagina to prevent discharge from getting into the urine.

The following values ​​are taken as the norms for indicators in women during pregnancy: leukocytes - up to 2000 per 1 ml, erythrocytes - up to 1000 per 1 ml, cylinders up to 20 per 1 ml. A poor urine test during pregnancy does not always mean pathology. For example, if the Nechiporenko test did not confirm deviations in the clinical analysis, then the reason is the lack of preparation (ingress of vaginal discharge, blood during menstruation, etc.). It is required to carry out hygiene of the genitourinary organs before collecting material.

Self-determination of pH

It is impossible to objectively assess the level of urine acidity through a single analysis. If indicators of acidification or alkalization occur, it is necessary to monitor the pH. Self-assessment is mandatory for people with chronic pathologies:

• diabetes;
• chronic pyelonephritis;
• respiratory and respiratory acidosis;
• chronic renal failure;
• metabolic alkalosis;
• kidney stones and urolithiasis.

It is recommended for women during the perinatal period to regularly measure acidity. There are several ways to determine acidity values ​​at home.

Alkalinization of urine

If the pH is elevated, it means that the urine is predominantly alkaline. A high level of alkali indicates the development of acute conditions, the progression of chronic diseases, and poor nutrition. The following are the causes of alkalinization of urine:

An alkaline reaction can be caused by inflammatory dental diseases, due to a violation of the acid-base balance of the oral cavity. If there are stable deviations in the acid level (regardless of its increase or decrease), it is necessary to examine the kidneys and take a general and biochemical blood test. If pathological changes are not detected, you should adjust your diet, physical activity and give up alcoholic beverages.

Children's indicators

In an infant, the acidity of urine depends on the feeding habits (artificial formula or natural feeding), as well as on the time of birth relative to the duration of pregnancy (term or premature).

Unstable pH in a newborn baby does not cause concern, provided that there are no genetic pathologies or congenital developmental abnormalities. Normalization of the level occurs on days 3–4. In children and adolescents up to adulthood, the normal pH of urine falls within the range of 6.5 to 7.5 units.

Level in adult men and women

The acidity level in adult men is affected by muscle mass (MM); in women, it is influenced by the perinatal period and lactation. During pregnancy, a slight excess of reference values ​​is allowed.

Deviations of a short-term nature are observed at night and in the morning (before breakfast). The pH level can drop to 5.2 units. in the morning, and increase in the evening to 7 units. Such “swings” do not pose any danger. A constant acidity value in the morning and evening, which does not go beyond the normative limits, does not apply to pathologies. If during the day the reaction remains stably acidic or stably alkaline, there is a need for additional examination.

It is impossible to objectively assess the level of urine acidity through a single analysis. If indicators of acidification or alkalization occur, it is necessary to monitor the pH. Self-assessment is mandatory for people with chronic pathologies:

Urine acidity is an indicator that reflects the concentration of hydrogen ions in urine. In the laboratory, the test is performed using a pH meter or an indication method. The pH value determines the acid-base balance. The test is performed if urolithiasis, urethritis, glomerulonephritis and other urological diseases are suspected. The acidity of urine determines changes in the acid-base balance of the body, which affect metabolism in the kidneys.

• What does urine pH mean?
• What determines the acidity of urine?
• How to properly prepare and collect material for analysis
• Acidity rate
• In children
• Among women
• In men
• How to determine pH at home
• Causes of acidic urine reaction
• Causes of alkalization
• How to normalize the acid-base ratio