High blood pressure and protein in urine pregnancy

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Testing for protein in your urine (proteinuria) is a routine test that your midwife will do at every antenatal appointment.

Having small amounts of protein in your urine is common in pregnancy. It can happen for a number of reasons.

There’s a chance the sample could be contaminated by discharge from your vagina. That’s why your midwife asks you to take the sample from your wee mid-stream.

Protein in your urine could also mean that your body is fighting a minor infection. Your midwife may send your sample to the hospital to check if you have a urinary tract infection (UTI). If you have a UTI, your doctor will prescribe an antibiotic that’s safe to take in pregnancy.

Your midwife will add your proteinuria levels to your maternity notes. She’ll note down whether you have the lowest amount, called a trace level, or more, which is marked with a +, ++ or +++ depending on how much protein is present. Ask your midwife to explain the result if you’re not sure what it means for you.

Depending on the proteinuria levels, your midwife may bring forward your next antenatal appointment. She’ll check again to see if there’s still protein present, and whether the amount has increased.

Your midwife will be especially vigilant about protein in your urine if you’re in the second half of your pregnancy, as it may be a sign that you’re developing pre-eclampsia, a potentially serious condition.

What is pre-eclampsia and what are the warning signs?

Midwife Suzanne Barber explains the warning signs of pre-eclampsia.More pregnancy videos

Pre-eclampsia is thought to be caused by the placenta not working properly. It can increase your blood pressure and affect how well your kidneys filter your blood. Protein in your urine alongside high blood pressure can be a sign of pre-eclampsia.

If your urine sample contains high levels of protein, and your blood pressure is raised, your midwife may take a blood sample. This will check your blood count, clotting, kidney and liver function.

If your midwife is concerned about your proteinuria levels, or any other symptoms you have, such as high blood pressure, she may send you to your local maternity unit or hospital for more tests. If the proteinuria is found to be at safe levels and there are no other concerns, you’ll be able to go home again. But if there are still concerns, you’ll need to stay for further monitoring.

Keep an eye out for other symptoms of pre-eclampsia from mid-pregnancy onwards, including:

• Severe headache.
• Problems with vision, such as blurring or flashing before your eyes.
• Severe pain just below your ribs.
• Vomiting.
• Sudden swelling of your face, hands or feet.

These symptoms can come on quickly. Call your doctor or midwife immediately if you notice any of them. This is especially the case from 27 weeks of pregnancy, or in the first few days after giving birth, when it is most likely to happen. However it can happen earlier than this, or later, up to four weeks after you've given birth.

Learn more about pre-eclampsia.

Joanne Lewsley is a freelance copywriter and editor, and specialises in creating evidence-based parenting, health and lifestyle web content.