- Urine Tests During Pregnancy
- Learning about ketones
- Checking for ketones
- When to call your health care provider
- Once you’re diagnosed with gestational diabetes
- Gestational diabetes treatment
- Amy Campbell, MS, RD, LDN, CDE
- Ketones, ketosis and ketoacidosis
- What can I do if I have ketones in my urine sample?
- Increasing carbs v’s higher blood sugar levels – “Should I go keto?”
- DKA (Ketoacidosis) & Ketones
- DKA (Ketoacidosis) & Ketones
- What are the warning signs of DKA?
- How do I check for ketones?
- What if I find higher-than-normal levels of ketones?
- What causes DKA?
- Ketones in Gestational Diabetes
- Getting A Urinalysis: About Urine Tests
- How is a urine test performed?
- When are urine tests performed?
- What does the urine test look for?
- What can urine test results reveal?
Urine Tests During Pregnancy
Urine tests provide your doctor or midwife with important information about diseases or conditions that could potentially affect you or your growing baby. That’s why at each prenatal visit, you’ll be asked to give a urine sample as part of your regular exam.
This sample is used to help determine if you have diabetes, kidney disease, or a bladder infection by measuring the levels of sugar, protein, bacteria, or other substances in your urine. The test is routine and painless and could prevent a lot of trouble down the road.
What does a urine test involve?
Urine can be collected any time of day. You will most likely be given a sterile cup to collect a sample before your exam. Before urinating, use a sterile towelette to wipe your genitals from front to back, and then release a small amount of urine into the toilet — this prevents the sample from being contaminated with bacteria or other secretions that may invalidate the results. Put the container in your urine stream, and collect at least one to two ounces.
This sample is then checked with chemically treated testing strips or sticks, and the results are usually available right away. If more analysis is necessary, your urine may be sent to a lab for additional assessment.
What can a urine test detect?
Typically, there is very little or no sugar (glucose) in urine during pregnancy. But when blood sugar levels in the body are too high, excess sugar can end up in the urine. This can be seen with gestational diabetes, a form of diabetes that only develops during pregnancy. It occurs when pregnancy hormones disrupt the body’s ability to use insulin, a chemical that turns blood sugar into energy.
A doctor often orders a blood test for diabetes early in your pregnancy if he or she knows you have other risk factors, like a personal or family history of gestational diabetes. And most doctors routinely screen for diabetes with blood tests between weeks 24 and 28 even if you have no known risks for diabetes. The screening test usually used is the one-hour oral glucose test, in which blood is tested for glucose one hour after drinking a sugary solution.
Each year, about 135,000 American moms-to-be are diagnosed with gestational diabetes — and many of them had no symptoms. If you have gestational diabetes, it can often be controlled through diet and exercise and daily self-testing of blood sugar. Some women take insulin as part of their treatment plan.
Remember that most women with diabetes deliver healthy babies. But left unchecked, babies of mothers with gestational diabetes are more likely to weigh more than 9 pounds, sometimes making vaginal delivery difficult. Even more important, uncontrolled glucose levels throughout pregnancy can also lead to an increased risk of heart, kidney, and spine defects in your newborn.
Even if your urine test results are fine, most women also have blood drawn for a glucose test between weeks 24 and 28. But don’t fret: One unusually high sugar level doesn’t mean you have diabetes — having a sweet drink or large meal too close to the time of the test can also cause a high reading. Your doctor will order a follow-up test to see if you truly have gestational diabetes.
Protein in urine (proteinuria) can indicate a urinary tract infection (UTI), a kidney infection or chronic kidney disease. When proteinuria develops later in pregnancy, it can be an early sign of preeclampsia, a pregnancy-related condition that can cause high blood pressure after the 20th week of pregnancy, and increase the risk of serious complications for mom and baby. Preeclampsia complicates about 7 percent of all pregnancies, and women with preeclampsia usually need immediate treatment to prevent problems with their health and delivery.
If you have proteinuria and your blood pressure is in the normal range, your health-care provider may order a urine culture to determine if an infection is causing the proteinuria. The culture can also identify the bacteria, allowing your provider to target the infection with the right antibiotic. You may have to wait 48 to 72 hours for the results. In the meantime, your provider may opt to start you on antibiotics. (Rest assured, several types of antibiotics are considered safe for pregnant women.) Your doctor may also ask you to collect urine over 24 hours to quantify the amount of protein in your urine.
If you have preeclampsia, your doctor will monitor you and your baby and may recommend bed rest to lower your blood pressure. Once doctors diagnose preeclampsia, they often recommend inducing labor or performing a caesarean once they know the baby is viable. The problem is when doctors are not sure if it’s preeclampsia. In these cases, more tests are ordered, and women sometimes have to be admitted to the hospital for observation until the diagnosis is confirmed or until the baby is delivered.
If it looks like you or your baby is in danger, your doctor may recommend inducing labor or performing a cesarean section ahead of schedule. Delivery is the only “cure” for preeclampsia.
The presence of bacteria in urine is a clear sign of a UTI. Up to 8 percent of pregnant women get UTIs, but many don’t have any symptoms. However, a symptomless infection can still spread to the kidneys and cause significant problems for you or your baby. Treated quickly and properly, UTIs rarely lead to further complications. But left untreated, they can damage your kidneys and elevate your risk of having a low birthweight or premature baby.
A urine test strip does not detect bacteria, but it can detect an enzyme that is a sign of a urinary tract infection. A test strip can also detect nitrites in the urine, which are secreted by some bacteria.
If this test is positive, practitioners usually recommend following up with a urine culture to confirm the presence of bacteria and which antibiotics will work best. Pregnant women (even if they don’t have symptoms) who have bacteria in their urine should always be treated with antibiotics. Several types of antibiotics are considered safe for pregnant women, but be sure to consult with your doctor before taking any antibiotics.
In fact, doctors usually order a urine culture at the beginning of a pregnancy so that they can identify and treat any symptomless bacterial infections that could cause complications later on.
When fat is broken down for energy instead of carbohydrates, the results are acidic byproducts known as ketones. If you have diabetes, large quantities of ketones in urine may indicate a harmful condition called ketoacidosis, which can lead to diabetic coma.
If exceptionally high levels of ketones are found in your urine, your doctor will investigate whether your eating or drinking habits are to blame. If a doctor determines that the presence of ketones in a pregnant woman’s urine can be blamed simply on not eating enough, and they disappear after she eats, then hospitalization isn’t necessary. If severe nausea and vomiting affect your ability to keep food or fluids down, you may need to receive nutrients through an intravenous line. Treatment for ketoacidosis, which can be an acute condition, usually takes place in a hospital.
Protein, sugar, bacteria, or ketones in your urine can spell trouble for you and your baby, but prompt testing and proper treatment can help prevent any problems. That said, the vast majority of pregnant women can breathe easy: Most urine test results reveal that all is well.
Nemours Foundation. Urine Tests. http://www.kidshealth.org/parent/general/sick/labtest7.html
University of Texas-Houston Medical School. Clean Catch Midstream Urine. http://medic.med.uth.tmc.edu/ptnt/00000450.htm
American College of Obstetricians and Gynecologists. Pregnant Women Should Be Screened for Gestational Diabetes; Though No One Test Is Ideal. http://www.acog.org/from_home/publications/press_releases/nr08-31-01.cfm
New York-Presbyterian. Urinary Tract Infections (UTIs). http://www.nyp.org/health/cd_rom_content/adult/women/urinary.htm
National Kidney Foundation. Ten Tests Used for Diagnosing Kidney Disease. http://www.nkfdv.org/patientinfo/kidneydisease/tentests.html
Preeclampsia Foundation. About Preeclampsia. http://www.preeclampsia.org/about.asp
American Diabetes Association. Ketoacidosis. http://www.diabetes.org/type-1-diabetes/ketoacidosis.jsp
American Diabetes Association. Gestational Diabetes. http://www.diabetes.org/gestational-diabetes.jsp
Learning about ketones
Ketones are by-products of fat breakdown in your body. When found in your urine, they indicate that you’re not eating enough calories at regular intervals during the day or that your blood glucose is too high.
Small amounts of ketones in your morning urine can result from:
- not eating enough the previous day
- missing your bedtime snack
- not eating all the carbohydrate choices in your meal plan
- more exercise than usual on the previous day
Large amounts of ketones may be seen if you have:
- extreme morning sickness
- vomiting and diarrhea so you can’t eat or drink
- illness or infection
If you become sick, it’s even more important for you to regularly check your ketones.
Checking for ketones
You’ll check your urine for ketones each day and record the results. When you get up for the day, check your first morning urine.
Ideally, ketone readings should be negative to a trace.
When to call your health care provider
Call if you are sick and:
- your blood glucose levels are above your ideal level
- your urine ketones are moderate to large
- vomiting continues or diarrhea lasts longer than 4 hours
- you have a fever of 101.5 Fahrenheit or higher
Remember that ketones may be a signal that you need to eat more. The following will help to keep your ketones at a healthy level for you and your baby:
- Don’t skip meals or snacks.
- Eat three meals and three snacks every day.
- Eat all the carbohydrate choices in your meal plan.
- Include protein in each meal or snack.
If you’re a pregnant woman, probably one of the last things you want to hear is that you have gestational diabetes. Your thoughts might range from, “What did I do to cause this?” to “Will my baby be OK?” First, keep in mind that it’s perfectly normal to feel scared and worried. Second, while gestational diabetes (GDM) is indeed serious, remember that, with proper management, you can have a healthy baby.
Once you’re diagnosed with gestational diabetes
If you find out that you have gestational diabetes, be prepared to learn a lot about diabetes! You’ll likely be referred to a diabetes educator and/or a dietitian. You might also be referred to an endocrinologist, a doctor who specializes in diabetes and other endocrine disorders. In most cases, you’ll be seen by a member of your health-care team about every two weeks. Be prepared to start checking your blood glucose with a meter, following a meal plan, checking your urine for ketones, recording your food and glucose levels, and possibly starting on insulin. In other words, be prepared to do some homework! Your team is there to support you and make sure that you receive the right treatment.
Gestational diabetes treatment
There are a number of ways in which GDM is treated, and they all work together to help ensure that your blood glucose levels stay in a safe range throughout your pregnancy. Remember that the goal is to keep your blood glucose in a normal range; this is because, when blood glucose levels are too high, the extra glucose crosses the placenta to the baby. Too much glucose can cause your baby to be too large, and may cause other complications for both you and your baby during delivery and later on (such as type 2 diabetes).
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Nutrition and meal planning
The saying that “you’re eating for two” during your pregnancy is partly correct. You ARE eating for two, but you’ll need to pay careful attention to what, when, and how much you eat. A meal plan helps provide adequate nutrition for your baby, provides adequate calories and nutrition for you, helps to control blood glucose, and prevents ketone formation. Your meal plan should be tailored to you (hence the importance of seeing a dietitian) and will be controlled in carbohydrate, with an emphasis on portion control and timing.
You do need to eat carbohydrate during your pregnancy; in fact, about 40% to 45% of calories should come from carbohydrate. The amount of carbohydrate that you need depends on your pre-pregnancy weight and level of blood glucose control. Meal planning methods might include following the Plate Method or counting servings or grams of carbohydrate. In terms of weight gain, your obstetrician will discuss with you the recommended amount of weight to gain during pregnancy. If you are overweight, your weight gain target might be lower. A meal plan can help ensure that you gain the right amount of weight. Be prepared to keep food records and bring them to your appointments. Also, you may need to work closely with a dietitian during your pregnancy.
Blood glucose monitoring
In order to know what’s happening with your blood glucose levels, you’ll need to start checking your blood glucose with a meter, usually four times each day (before breakfast and one hour after the start of each meal). In general, blood glucose targets are less than 60 mg/dl to 95 mg/dl before breakfast, and less than 100 mg/dl to 129 mg/dl one hour after a meal. Keep a log of your glucose readings, as well. A diabetes educator should show you how to use a blood glucose meter and how to check your blood glucose using a lancing device. Practice checking your blood glucose while you are with the educator to make sure that you feel comfortable doing so and that you’re using your meter correctly (today’s meters are fast and easy to use!).
Urine ketone testing
Ketones are formed when fat is burned for fuel. If you have ketones in your urine during pregnancy, it may be a sign of what is called “starvation ketosis” — this means that you aren’t getting enough calories in your eating plan, and you may be losing weight, as well. (Starvation ketosis is not the same thing as diabetic ketoacidosis, a very serious condition that can occur in people with type 1 diabetes and in those with type 2 diabetes who take insulin).
In order to check for ketones, you’ll need to purchase ketone strips at your pharmacy. You’ll get a sample of urine in a clean container and dip the ketone strip into the urine. A pad on the strip will change color after a certain amount of time (follow the instructions on the container). You’ll then compare the color on the strip to the color on the container to determine the amount of ketones in your urine. The presence of ketones with a normal blood glucose levels usually means that you need to eat more; this is often done by eating a bedtime snack. Ketones along with a high blood glucose reading may indicate a need for insulin.
Yes, physical activity is an important part of the treatment plan! Physical activity helps with blood glucose control, can reduce insulin resistance, and can prevent excessive weight gain. Talk with your obstetrician about how much activity is safe for you to do, as well as at what level of intensity. Walking and swimming are good choices, but there are other options, too. There may be types of activities that you should avoid, as well, such as contact sports or scuba diving. Aiming for about 30 minutes each day is a good goal, ideally, after eating a meal (when your blood glucose will be at its highest).
Want to learn more about treatment for gestational diabetes? Read “Gestational Diabetes: More Treatment Approaches” and “Glucose Test During Pregnancy for Gestational Diabetes.”
A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com
Ketones, ketosis and ketoacidosis
It should also be noted that babies are naturally in a state of ketosis during growth in the womb which is actually essential for development of the brain and nerve cells. Also, following birth, ketones account for 25% of the newborn’s energy needs.27
One study suggests that ketonuria may cause problems in pregnancy and it is this study that has led to the recommendation to avoid ketosis in pregnancy.
The 1969 study published in American Journal of Obstetrics and Gynaecology28 found that excess urinary ketones in pregnancy may affect developing brain cells of the baby, leading to a lower IQ and future learning disabilities. However, this study was not reliable as blood ketones were not tested in this study, which we know are the best way to ascertain true ketone levels and only one single sample of urinary ketones were tested on the day of birth.
Other studies since have not been able to confirm these findings.5,29
Some Trusts and Doctors feel safer testing for ketones and if any are found in urine, they prefer to treat them by flushing them through with fluids (this may mean encouraging drinking and/or being given IV fluids) and encouraging the mother to eat.
To avoid recurrence of ketones, they may advise on-going dietary changes to increase carbohydrates, which in turn may require medication or insulin to help lower blood sugar levels that may rise in line with eating more carbohydrates.
What can I do if I have ketones in my urine sample?
Firstly, think about reasons why ketones may be present in your urine sample:
- Is your sample following a period of fasting e.g. first thing in the morning, or after skipping a meal or snack?
- Are you possibly dehydrated? How much have you had to drink and has anything else impacted on you becoming more dehydrated than usual e.g. have you had more exercise than normal, is it a much warmer day?
If you can answer yes to either or both situations above then it is to be expected that you will have ketones in your urine sample. You simply need to have something to eat and to increase your fluids.
What is the level of ketosis and do you have any other symptoms?
Your medical professional should advise if there is any concern over the level of ketones present. Often trace or small amounts may be shown as mentioned above. But if you have any worries, discuss any concerns with your healthcare professional.
If the urinary ketone level is low and you have no other symptoms of feeling unwell, then it suggests that this is just mild ketosis and most probably caused by one of the 2 reasons suggested above.
If you have higher levels of urinary ketones, then your medical professional may suggest drinking, eating and/or increasing the amount of carbohydrates in your diet.
Having a bedtime snack has been associated with lower ketone levels.30 This does not mean that you MUST eat a bowl of cereal or a slice toast before bed, or for breakfast (which has previously been suggested by some medical professionals to mothers in our support group). You can increase carb amounts with safer carb choices which tend to be tolerated better and give lower blood sugar levels.
Cereals are never going to be a type of food we recommend eating, due to our own surveys on the matter showing it is very rare for women with GD to tolerate it. Therefore, we advise trying better alternatives, which will release glucose at slower rates e.g. Scottish oatcakes, Ryvita, wholewheat crackers, a slice of Hi-Lo or Burgen soya & linseed bread, paired well with plenty of protein and natural fats.
Admitted to hospital due to ketones, have they tested blood ketones?
In more severe cases, you may be admitted to hospital for intravenous fluids and a sliding scale.
In some cases we see mothers admitted for long periods of time and the medical professionals have only tested for urinary ketones.
If capillary blood ketones have not been tested and urinary ketones are still showing (therefore meaning the hospital is advising that you should not leave due to the presence of urinary ketones), yet you feel fine, ask them to test the levels of ketones in your blood.
They may find that blood ketones are actually at very low/trace levels.
As mentioned at the start of this article5
urinary ketones may increase 50-100-fold while blood ketones will only rise 2-fold and remain below ketonemic levels (at or above 1mmol/L)… Hence positive Ketostix tests in urine samples do not indicate toxic levels in the blood.
Increasing carbs v’s higher blood sugar levels – “Should I go keto?”
Only you can decide if you would feel comfortable following a lower carb or keto diet during pregnancy and no one can force you to eat anything you do not wish to.
The diet we advocate is low carb and high fat, similar to the keto style diet, but incorporating small servings of starchy unrefined complex carbs with each meal. Therefore it incorporates higher amounts of carbs than a ketogenic diet.
We have found this is a good balance between achieving good blood glucose management and prevention of moderate urinary ketosis.
If you are used to following a keto diet previous to pregnancy, then you may find it better for you to continue. However if you have concerns over ketosis and the effect it may have on your baby, then increasing carbs may be a more suitable option for you.
If you would like to read more on ketosis in pregnancy, then I highly recommend reading Chapter 11 of Lily Nichol’s book, Real Food For Gestational Diabetes26. Lily’s book chapter is the most in depth review of literature on ketosis in pregnancy that I have found and goes into so much detail.
DKA (Ketoacidosis) & Ketones
DKA (Ketoacidosis) & Ketones
Diabetic ketoacidosis (DKA) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death.
When your cells don’t get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. The body does this when it doesn’t have enough insulin to use glucose, the body’s normal source of energy. When ketones build up in the blood, they make it more acidic. They are a warning sign that your diabetes is out of control or that you are getting sick.
High levels of ketones can poison the body. When levels get too high, you can develop DKA. DKA may happen to anyone with diabetes, though it is rare in people with type 2.
Treatment for DKA usually takes place in the hospital. But you can help prevent it by learning the warning signs and checking your urine and blood regularly.
What are the warning signs of DKA?
DKA usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms include the following:
- Thirst or a very dry mouth
- Frequent urination
- High blood glucose (blood sugar) levels
- High levels of ketones in the urine
Then, other symptoms appear:
- Constantly feeling tired
- Dry or flushed skin
- Nausea, vomiting, or abdominal pain
(Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your health care provider.)
- Difficulty breathing
- Fruity odor on breath
- A hard time paying attention, or confusion
Ketoacidosis (DKA) is dangerous and serious. If you have any of the above symptoms, contact your health care provider IMMEDIATELY, or go to the nearest emergency room of your local hospital.
How do I check for ketones?
You can detect ketones with a simple urine test using a test strip, similar to a blood testing strip. Ask your health care provider when and how you should test for ketones. Many experts advise to check your urine for ketones when your blood glucose is more than 240 mg/dl.
When you are ill (when you have a cold or the flu, for example), check for ketones every 4 to 6 hours. And check every 4 to 6 hours when your blood sugar is more than 240 mg/dl.
Also, check for ketones when you have any symptoms of DKA.
What if I find higher-than-normal levels of ketones?
If your health care provider has not told you what levels of ketones are dangerous, then call when you find moderate amounts after more than one test. Often, your health care provider can tell you what to do over the phone.
Call your health care provider at once if you experience the following conditions:
- Your urine tests show high levels of ketones.
- Your urine tests show high levels of ketones and your blood glucose level is high.
- Your urine tests show high levels of ketones and you have vomited more than twice in four hours.
Do NOT exercise when your urine tests show ketones and your blood glucose is high. High levels of ketones and high blood glucose levels can mean your diabetes is out of control. Check with your health care provider about how to handle this situation.
What causes DKA?
Here are three basic reasons for moderate or large amounts of ketones:
- Not enough insulin
Maybe you did not inject enough insulin. Or your body could need more insulin than usual because of illness.
- Not enough food
When you’re sick, you often don’t feel like eating, sometimes resulting in high ketone levels. High levels may also occur when you miss a meal.
- Insulin reaction (low blood glucose)
If testing shows high ketone levels in the morning, you may have had an insulin reaction while asleep.
Ketones in Gestational Diabetes
If you have gestational diabetes, you should know about insulin, glucose, and ketones.
When you eat, your body breaks down foods into usable sources of energy. Glucose is the sugar that results.
Your body needs glucose for energy and your baby needs it to grow. In order to get glucose out of your blood and into your cells, insulin is required.
Insulin is a hormone that you produce in your pancreas.
“In gestational diabetes, hormones produced during pregnancy can interfere with insulin and make it hard to use glucose. If the pancreas cannot produce enough insulin to overcome the effects of the hormones, the blood sugar will rise,” explains Louise McDonald, RN, clinical manager of maternity and pediatrics at Cleveland Clinic Home Care.
“The body cannot use sugar without enough insulin. That causes the body to break down fats as a source of energy. Ketones are the waste products that are left over when the body burns some of its own fat for fuel. The ketones pass from the bloodstream into the urine,” says McDonald.
Why Are Ketones Important in Gestational Diabetes?
The treatment of gestational diabetes is aimed at keeping your blood sugar under control. This is done with a combination of diet, exercise, and sometimes insulin treatment.
Finding ketones in your urine is a warning sign that your blood sugar control is out of balance.
- High blood sugar. If you are taking in more sugar in your diet than your insulin can manage, your blood sugar goes up. This is dangerous for you and your baby. If your baby is exposed to more sugar then the baby needs, the baby will grow too fast. This condition, called macrosomia, can lead to problems during delivery.
- Low blood sugar. Your body may also turn to fat as a source of energy if your blood sugar is too low. This can happen if you skip a meal or during the night when you go for a long period without eating. In some women who are overweight, a low-calorie diet may not be supplying enough sugar. Ketones in your urine may be a sign that you and your baby are not getting enough energy fuel in your diet.
- Ketones and your baby. Some studies have shown that excess ketones in a pregnant woman’s urine may affect developing brain cells and lead to babies with a lower IQ and future learning disabilities. Although other studies were not able to confirm these findings, many doctors feel safer testing for ketones and avoiding them by adjusting your diet or medication.
Gestational Diabetes: How and When to Test Your Urine for Ketones
The recommended time for women with gestational diabetes to test for ketones is in the morning to see if the baby is receiving enough nutrition through the night. Testing is quick and simple: A ketone dip-and-read test strip, available at a pharmacy, is dipped into a morning urine sample. If the strip changes color, ketones are present in the urine.
“Ketone test strips are sensitive to light and moisture, so it is a good idea to keep them stored in the container with the lid on tight. Check the expiration date on the bottle and do not use strips that are expired,” says McDonald.
If you have gestational diabetes, you need to keep your blood sugar under control. Testing for ketones in your urine is one of the ways that you and your gestational diabetes management team can know how you are doing. Occasional ketones in your urine are not unusual and may not signal a big problem, but always let your management team know and work with them to get your blood sugar under control. Keeping ketones out of your urine is one way to make sure you are doing what’s best for you and your baby.
Getting A Urinalysis: About Urine Tests
A urine test is a routine test used by your healthcare provider as part of your prenatal care. Although urine tests are used in screening for pregnancy, this article is discussing urine tests as part of your routine prenatal care.
How is a urine test performed?
Your healthcare provider will ask you to collect a small sample of clean, midstream urine in a sterile plastic cup.
Chemically prepared testing strips are dipped into your sample of urine to screen for certain indicators.
A more in-depth analysis may be done by having your urine sample assessed by a laboratory.
When are urine tests performed?
A urine test should be expected during your first prenatal exam and then at least periodically in future prenatal visits.
It would be normal for your healthcare provider to monitor your urine during each visit.
What does the urine test look for?
A urine test is used to assess bladder or kidney infections, diabetes, dehydration, and Preeclampsia by screening for high levels of sugars, proteins, ketones, and bacteria.
High levels of sugars may suggest Gestational Diabetes, which may develop around the 20th week of pregnancy.
Higher levels of protein may suggest a possible urinary tract infection or kidney disease.
Preeclampsia may be a concern if higher levels of protein are found later in pregnancy, combined with high blood pressure.
What can urine test results reveal?
Sugar: Sugar in your urine does not mean you are diabetic.
It is normal for your kidneys to leak sugar from your bloodstream into your urine. This is particularly expected if you eat a large meal or drink a really sweet beverage.
You should be tested for gestational diabetes if:
- Consistent levels of sugar (glucose) are detected and/or
- You feel tired or lethargic
- You are consistently thirsty
- You are losing weight
If protein is found in your urine late in pregnancy this may be a sign of preeclampsia.
Your healthcare provider will examine you for preeclampsia if:
- Consistent levels of sugar (glucose) are detected
- You have high blood pressure
- You have swelling in your face and hands
High levels of ketones indicate you are not getting enough to eat or that you may be dehydrated.
Your healthcare provider may retrieve a second urine sample collected through a catheter before determining the type of antibiotics needed.
Compiled using information from the following sources:
1. March of Dimes
2. Nemours Foundation