[BabyRN2Be]

I have a doula client who is 28 weeks and she says her doctor has moved her into a "high risk" category. She states that she is "spilling protein +2". I'm not at the point at which I've studied these lab values, but is +2 actually spilling protein? I know the doctor who she's working with, and this doctor tends to be very conservative and has a high c/s rate. I think that she's possibly scaring this patient. She's been sent to a nephrologist and a perinatologist who do not agree with her original OB's findings. Now my client doesn't know who she should trust.

I'm wondering if +2 is actually "spilling protein" or if this is mild protein in her urine. Thanks for your help!

[SmilingBluEyes]

Not NEAR enough info by far.
IF they are concerned, ("high risk" on this one protein test alone?)----they need to do a 24-hour urine to be sure and capture a real portrait of her "protein-spilling" problem. Also, there are other things to consider like , her serial blood pressures, (does she have a hx of high blood pressure either during or before pregnancy?), possibly needing liver enzymes/profile and platelet counts, and also maybe d-dimer tests to do. Also what is her kidney function like? Was it a concern before pregnancy? Is she diabetic? So much to consider.. But to answer your question, yes, I would be concerned about 2+ protein in urine with a 28-weeker and would look more deeply and investigate what else may be going on. I am hoping her doctor is doing all this already, as well. DO let us know how she is doing, OK? I am curious what happens w/her.

[purplemania]

agree with last post. Normally, protein molecules are too large to get filtered thru kidneys. So there should be ZERO protein in our urine. If it is there then something is not right and the patient needs further assessment.

[BabyRN2Be]

Originally Posted by SmilingBluEyes

Not NEAR enough info by far.
IF they are concerned, ("high risk" on this one protein test alone?)----they need to do a 24-hour urine to be sure and capture a real portrait of her "protein-spilling" problem. Also, there are other things to consider like , her serial blood pressures, (does she have a hx of high blood pressure either during or before pregnancy?), possibly needing liver enzymes/profile and platelet counts, and also maybe d-dimer tests to do. Also what is her kidney function like? Was it a concern before pregnancy? Is she diabetic? So much to consider.. But to answer your question, yes, I would be concerned about 2+ protein in urine with a 28-weeker and would look more deeply and investigate what else may be going on. I am hoping her doctor is doing all this already, as well. DO let us know how she is doing, OK? I am curious what happens w/her.

Yes, I knew I had asked at the right place... thanks, Deb!

Here's the kicker... the doc has her all upset because of this protein spill. As far as she's told me, her BP is fine - always has been, not diabetic, her kidney function has always been good, the nephrologist doesn't agree that this is a problem. I do a health history on clients and everything is fine. This doctor really has my client worried, and I was wondering what a +2 protein spill signified. All she's told her is that she has a 25% chance of preemclampsia, and she's scared. Hopefully she'll know tomorrow and I'll get a chance to talk with her before I go out of town next week.

[SmilingBluEyes]

well then i would request a deeper evaluation. really best way is a 24 hour urine test.