Analysis of urine during pregnancy transcript. Urine analysis in pregnant women. It is possible to defeat severe kidney disease

14.04.2019

Of all types of diagnostics, urinalysis during pregnancy plays a primary role. If you look at the calendar of tests that pregnant women have to take, you can see that the most frequent, regular test is a urine test. The woman is assigned to this test every time she visits the gynecologist.

In the normal course of gestation (pregnancy), the expectant mother should visit the gynecologist about twenty times. Thus, she needs to have an average of twenty urine tests during her current pregnancy. This, we note, is only under the condition of normal gestation! In cases where there are deviations in the results of laboratory diagnostics, there may be more such analyzes. There are also special types of urine analysis, which are assigned separately, for example, the "Zimnitsky test".

Urine

In Latin, urine is called urina (urine) - this is a type of excrement (excrement) of living organisms, formed in the course of their vital activity.

The kidneys, while performing the function of purifying the blood from substances unnecessary for the body, filter the blood plasma. As a result of their work, the so-called primary urine is formed. This fluid is reabsorbed to "secondary urine", which is excreted from the kidneys through the ureter to the bladder and from there through the urethra outside.

Analysis of urine

A general urine test can tell a lot about the patient's health to the gynecologist. For example, it can show pregnancy, although there are not so many cases when a doctor specifically prescribes a urine test for pregnancy. To determine pregnancy, it is customary to use other types of diagnostics - a blood test or a home test (expectant mothers call it a "pregnancy test"). Determination of pregnancy according to the results of urine analysis is possible due to an increase in the content of the hormone hCG (hormone of pregnant women) in it. The rest of the tests follow the same principle.

Urine collection rules

For laboratory research, morning urine is used. It is believed that urine, which is collected in the bladder during sleep, is more suitable for obtaining objective data on the patient's health.

Urine should be collected in special factory-made containers that are sold in any pharmacy. The advantage of these containers over any others is obvious - their sterility is guaranteed by the manufacturer, which cannot be said about the various jars and flasks available in abundance in the household.

In total, about 50 ml of liquid will be needed for analysis. It is necessary to collect the urine that flows out at the end of the act of urination. A cotton swab should be used to isolate urine from the vaginal environment. On the container, you must legibly write your data - name, surname, date of birth. Thanks to these simple steps, you can avoid possible confusion with other people's analyzes.

The container must be transported in such a way that it is kept warm. A low temperature, and this will be considered an air temperature below 10 ° C, affects the urine, causing sediment. Sediment is a parameter of the clinical study of urine, and therefore it can be misinterpreted as an indicator of renal failure of a pregnant woman.

On the eve of urine collection - at least 12 hours before the start of the procedure - you must refrain from taking medications (vitamins, antibiotics, steroids) and foods that can change the color of urine, such as beets or blueberries.

In the process of collecting urine, genital hygiene is important, any dirt can affect the analysis parameters. It is necessary to refuse sexual intercourse at least 10 hours before the collection of urine.

Types of urine tests

In medical clinical practice, there are various urine analyzes: general urine analysis, Nechiporenko's test, Sulkovich's test and Zimnitsky's test. Some are needed during gestational follow-up, and some are not. In any case, you need to know about them in order to figure out what specific type of urine analysis was prescribed during pregnancy and what it is needed for.

General urine analysis (clinical urinalysis)

The most informative and most common type of urine analysis in medical practice is the clinical analysis of urine.

It includes organoleptic (amount, color, foaminess, transparency, odor), physicochemical (density, acidity) and biochemical (protein) studies, as well as microbiological (detection of gram-positive and gram-negative bacteria, fungal infections) examination and microscopic examination of urinary sediment (organized and unorganized types of sediment, cylindruria).

Urine analysis according to Nechiporenko (Nechiporenko test)

This type of laboratory research is focused exclusively on the detection of leukocytes, erythrocytes and cylinders in urine. The sediment content is estimated in relation to 1 ml of urine. The analysis is carried out to detect infectious invasions of the genitourinary system, to check the functions of the kidneys, urethra, and bladder.

This type of diagnosis is used during the monitoring of gestation in cases where the general clinical analysis showed deviations from the norm, indicating the presence of infection. The function of the Nechiporenko test in this case is to give a more complete clinical picture of what is happening in the woman's body. This analysis is also prescribed when there is a suspicion of inflammation of the organs of the genitourinary system.

Norms of analyzes according to Nechiporenko:

Urine analysis according to Sulkovich (Sulkovich test)

This type of clinical research is not focused only on pregnant women, its primary goal is newborns and small children, rarely adult patients. Given that the pregnancy will not last forever, a young mother will probably be interested in knowing what awaits her newborn baby after birth.

Using the Sulkovich test, the amount of calcium in urine is determined. A deficiency or excess of this trace element in the child's body will indicate the presence of certain pathologies or an improperly constructed diet. The Sulkovich test is often used to accurately calculate the dosage of vitamin D for infants.

Urine analysis according to Zimnitsky (Zimnitsky test)

Zimnitsky's test is a type of diagnosis, the purpose of which is to obtain information about the throughput and concentration of the kidneys, i.e. how many liters of urine can pass through the kidneys in one day. With the help of this type of analysis, the potential of the urine dilution function is also assessed (in the kidneys, urine is divided into primary and secondary urine using the osmosis phenomenon, if there are many useful substances in the secondary urine, this indicates a poor dilution function).

The analysis is used to diagnose pregnant women in cases where the attending physician needs to clarify the clinical condition of the patient.

The normal indicator of the analysis is the complete absence of glucose and polypeptides in urine. If they are present in a woman's body, in her genitourinary system, then this will be evidence of an inflammatory process.

Bacteriological analysis of urine (BAC urine culture)

During routine clinical urine testing, a laboratory technician examines the microscopy of the sediment. If bacteria and fungi are found in a concentration higher than normal, then bacteriuria will be indicated in the conclusion. Such an indicator will inevitably mean the need for a deeper study aimed at a specific definition of microorganisms found in the sediment - LHC urine culture.

LHC urine culture is required during gestation. He is prescribed twice - at 9-12 weeks, after the woman was able to become pregnant, and at 35-36 weeks, i.e. in the first days of the ninth month. Of course, if a woman has an infection, then a bacterial urine test may be performed more often.

The interpretation of the examination result depends on the indications of other tests - general blood and urine tests, as well as on the type of pathogen, the general condition of the body and the presence of toxicosis. The rate of bacterial analysis of urine during pregnancy is almost the same as in a person in a normal state:

Less than 1000 CFU / ml (colony forming units per ml) - negative result (no infection).
More than 1000 CFU / ml, but less than 10,000 CFU / ml - the result is doubtful, a second examination is prescribed.
More than 10,000 CFU / ml - the result is positive (there is an infection).

Explanation of the results of clinical analysis of urine in pregnant women

We will give a decoding of the results of the clinical analysis of urine in pregnant women according to the table, which displays typical indicators for a healthy woman.

Indicators	The values
Amount of urine	1500-2000 ml
Colour	Straw yellow, amber yellow
Transparency	Full
Density	1,010-1,030
PH	5,0-7,0
Protein	Up to 0.033 g / l
Glucose	Missing
Bilirubin	Missing
Urobilinogen	Traces
Ketone bodies	Absent
Erythrocytes	1-2 in sp.
Leukocytes	Up to 5 in p. Sp.
Epithelium	Single cells of squamous and transitional epithelium
Cylinders	Single hyaline cylinders
Salt	Single urates and oxalates

For an in-depth understanding, a more complete decoding of the parameters of urine analysis during pregnancy will be given below.

Amount of urine

The process of excretion of urine for a certain unit of time is called in medicine "diuresis". Distinguish between daily, day and night types of diuresis. In a person in a normal state, it corresponds to 70-80% of the liquid drunk. The rate of fluid consumption is 1.5-2 liters. In pregnant women, this indicator is normally increased by a quarter. This is due to the more intense work of the kidneys.

Colour

Urine color is an important indicator of a person's health. Diagnosing the color of the urine of an ordinary person is no different from diagnosing the color of urine in a pregnant woman. A more deciphered parameter of urine color in this video:

Transparency

Normal urine should be clear. If it is cloudy, you need to find out what is the reason for the cloudiness - in bacteria, erythrocytes, fat, mucus, salts or protein suspension. For this, additional research is carried out - they heat, shake the urine; add alkali, acetic acid to urine; examine the urine under a microscope.

Density

This parameter is directly dependent on the liquid drunk by the woman per day and, in general, on the content of various solutes in the urine.

The indicator of the norm of urine density in a pregnant woman is 1004-1034 g / l.

A high density will indicate dehydration. Dehydration can be caused by glomerulonephritis, toxicosis, diabetes mellitus.

PH

Urine PH has a range from 5.2 (acidic) to 8.2 (slightly alkaline). A low pH (acidic environment) creates good conditions for the development of bacteria, and therefore is undesirable.

Protein

In humans, in the normal state, protein should be absent in urine, in pregnant women, a small amount of it is permissible - up to 0.034 g / l.

Protein above this value will be a possible indication of an infectious lesion of the genitourinary system or severe toxicosis.

Glucose

During pregnancy, the rate of glucose in the blood ranges from 3.2 to 5.4 mmol / l. A value below the lower threshold is hypoglycemia, above the upper one - hyperglycemia.

It is important for pregnant women to monitor their blood glucose levels, as the risk of gestational diabetes increases during the third trimester of pregnancy.

Bilirubin and urobilinogen

A healthy woman should not have these substances in the urine. Their presence is a signal that there are problems with the liver - the higher the concentration of these substances, the greater the problem.

It is necessary to collect the middle portion of the morning (immediately after sleep) urine in a special sterile container for analyzes with a plastic cap.

On the eve of sampling, exclude the intake of medications (vitamins, diuretics, hormonal, antibiotics and other medicines) and coloring food (carrots, beets, asparagus, cranberries, blueberries, etc.).

The last sexual intercourse must be at least 12 hours before the collection of the urine sample.

First of all, before collecting urine, it is necessary to thoroughly hygiene the external genital organs. To prevent the vaginal environment from entering the urine sample, cover the vaginal opening with a piece of cotton wool or insert a tampon. Avoid touching the urine collection container with your body.

When urinating, flush the first portion of urine (1-2 seconds) into the toilet, and then, without interrupting urination, collect the second part of urine, interrupting at the end of the process and ending urination into the toilet. For the analysis, you need about 50 ml of biomaterial.

The collected urine must be delivered to the laboratory within 1-1.5 hours. On the test jar, legibly indicate your last name, initials, date of test collection and time.

Decoding urine analysis during pregnancy

Laboratory research of this biological fluid includes the determination of its organoleptic characteristics, physical and chemical properties, biochemical composition and sediment microscopy.

Colour

In a healthy person, urine can have a color ranging from straw to deep yellow. Often, pregnant women have a bright yellow or orange color of urine, which is due to the intake of vitamins on the eve of the test.

When drinking plentifully, the urine becomes diluted and becomes colorless, and, conversely, when a small amount of liquid is consumed or when it is lost (vomiting, diarrhea), the urine becomes more concentrated, dark yellow.

A symptom of a disease is most often considered if the urine has a color:

strong tea ("beer" color) - pathology of the liver and gallbladder, for example, parenchymal (hepatic) jaundice or viral hepatitis;
pink-red (the color of "meat slops") - inflammation of the kidneys, for example, acute glomerulonephritis;
greenish-yellow ("lemon" color) - obstructive jaundice (ie gallstone disease), the presence or ingress of pus into the urinary system;
dark brown (dark brown) - hemolytic anemia;
whitish - the presence of a large amount of phosphates or lipids, for example, kidney lymphostasis, fatty degeneration of the kidneys;
milk - urinary tract infection, cystitis, pyelonephritis.

Transparency

Freshly collected, normal urine is ideally clear, possibly slightly cloudy, due to the presence of epithelium and mucus.

It also grows slightly cloudy due to prolonged standing of the sample, so the collected sample must be delivered to the laboratory as soon as possible so as not to distort the analysis result. A small amount of drinking water can also cause clouding of urine in a healthy person.

Pronounced turbidity of urine is caused by erythrocytes, leukocytes, bacteria, mucus, a significant amount of salts or epithelial cells, etc.

Specific gravity

This indicator depends on the amount of substances dissolved in the urine and the water drunk during the day.

The relative density (or specific gravity) of the urine of a healthy person is 1 003-1035 g / l.

An increase in density occurs with dehydration, toxicosis, uncontrolled diabetes mellitus, glomerulonephritis, etc., and a decrease - with abundant drinking, nephritis, renal failure.

pH

The reaction of urine in humans ranges from 5.0 (acidic) to 8.0 (slightly alkaline), depending on the diet. The acidity of urine is increased by protein (in particular, meat) products and fats, and vegetable products (fruits, vegetables) and dairy foods contribute to the alkalization of urine.

The reaction of urine in a healthy person with a balanced diet is slightly acidic (pH = 6.0 and>) or neutral (pH = 7.0).

An acidic environment is a good environment for the development of bacteria, so the presence of such an environment all the time is undesirable.

Kidney failure, urinary tract infections, and other diseases affect the rise in pH.

Diabetes mellitus, tuberculosis, fever, severe diarrhea and other ailments will affect the pH by lowering it.

Protein

Normally, there is no protein in the urine, but during pregnancy a slight increase up to 0.033 g / l is allowed, which is caused by strong emotional experiences for the health of the fetus, possible overheating in summer or hypothermia in the cold season, intake of undenatured protein food (raw eggs and homemade unboiled milk ), the presence of allergies at the time of the test, and indeed, a strong load on the kidneys.

Towards the end of the second trimester, a small amount of protein may appear due to mechanical compression of the kidneys by the pregnant growing uterus, but this phenomenon is not permanent, and is harmless only in the absence of other signs of kidney disease.

Also, protein can enter the urine along with vaginal discharge, therefore, in order for the analysis result to be as accurate as possible, it is necessary to follow all the rules for taking a urine sample.

The appearance of protein (proteinuria) indicates kidney disease (pyelonephritis, glomerulonephritis, nephropathy of pregnant women, etc.), urinary tract infections (cystitis, urethritis) or gestosis (late toxicosis).

Sugar

Normally, sugar in the urine of a healthy person is absent or is found in insignificant amounts up to 0.083 mmol / l.

During pregnancy, "traces" of glucose can be found in the urine. This happens due to heredity (especially with late pregnancy - after 35 years), with obesity, the use of high-carbohydrate foods or with severe stress.

In the second trimester of pregnancy, physiological glucosuria is observed, which is due to the normal processes occurring in the body of a pregnant woman. She does not require medical treatment, but nutrition should be adjusted to reduce the amount of carbohydrate food in the diet of a pregnant woman (limit the use of sweets and starchy foods).

Detection of glucose (glucosuria) is observed in diabetes mellitus, renal and other types of diabetes.

Bilirubin

In a healthy person, bilirubin is not detected in the urine. But with obstructive jaundice, viral hepatitis and other diseases that cause difficulty in the outflow of bile, the appearance of bilirubin is observed, and the urine turns dark, "the color of beer."

Ketone bodies

During pregnancy, these bodies can be determined in the urine, which indicates dehydration with early toxicosis. But this is not a trifle, ketone bodies poison the body with acetone, therefore, it is necessary to be examined in order to exclude other possible diseases (in particular, diabetes mellitus).

Acetone is most commonly found in the urine of anemia or gestational diabetes during pregnancy. In such cases, a dropper and a special diet are prescribed by a doctor at the hospital. The main goal is to drink more alkaline mineral water (Borjomi, for example), exclude sweets, fatty foods, reduce protein intake, and vice versa, include more carbohydrate foods in the diet.

Nitrite

They are not found in the urine of a healthy person. A positive result indicates the presence of an infection in the urinary tract.

Hemoglobin

Normally, there is no hemoglobin in the urine. Usually, its presence indicates hemolytic anemia.

Erythrocytes

In a healthy person, erythrocytes in the urine are either absent, or 1-2 cells are found in the field of view.

An increase in the number of red blood cells (hematuria) occurs in renal diseases and diseases of the urinary system.

Leukocytes

To fight the causative agents of various diseases, the body produces leukocytes. Normally, a woman's urine contains 0-5 leukocytes per field of view.

An increased content of leukocytes (leukocyturia) always indicates inflammatory processes in the kidneys - pyelonephritis, in the urinary tract - cystitis, urethritis or genitals.

Women who neglect personal hygiene and other rules when taking an analysis get an erroneously positive result.

An excessive increase in leukocytes (pyuria) can be detected even with the naked eye: the urine is cloudy, "flakes" and "threads" float in it. This indicates the addition of purulent to the inflammatory process.

Epithelial cells

The epithelium lines the mucous membrane of all internal organs. Squamous epithelium is almost always present in the urine sediment of a healthy person in an amount of up to 3 cells per field of view. Their number is increasing with an infectious disease of the urinary tract.

Another type of cells, transitional epithelium, appears in the urine with cystitis, pyelonephritis, and kidney stones. The presence of the 1st transitional epithelium cell in the field of view is acceptable.

The renal epithelium is found in the sediment with an infectious lesion of the renal parenchyma - pyelonephritis, kidney glomeruli - glomerulonephritis, etc. In a healthy person, the renal epithelium is absent in the urine sediment.

Cylinders

In kidney diseases, protein accumulates in the renal tubules, leukocytes, erythrocytes, exfoliated epithelial cells and other particles "stick" to it. This plastic mass envelopes the tubules, cylindrical in shape, from the inside, and thus makes, as it were, an impression of them. When urinating, these cylindrical casts are washed out and determined by a laboratory assistant during analysis.

Since protein and other elements are excreted in the urine only with a pathological state of the kidneys, then in a healthy person there should be no cylinders in the sample, only hyaline cylinders can be found and no more than 1-2 in the field of view, an increased content of this species or the presence of the rest (granular , waxy, erythrocytic, leukocyte, epithelial) is possible only with various renal diseases.

Bacteria and fungi

In the analysis of a healthy person, bacteria and fungi should be absent, their presence indicates an infection of the genitourinary system (cystitis, urethritis, candidiasis, etc.).

If bacteria are found in the urine, additional urine is taken for bacterial culture to determine the type of bacteria and their titer (amount). If necessary, antibiotic treatment is prescribed, to which this type of bacteria is sensitive.

Salt

Urine is an aqueous solution of decay products of protein substances and various salts that precipitate. The presence of a certain type of salt crystals in the urine indicates a change in pH in one direction or another. An acidic environment causes the formation of urates, an alkaline environment - phosphates. With normal other urine parameters, the presence of salts is not considered a sign of any disease.

Excessive salt content (urates, phosphates or oxalates) leads to the appearance of stones and, as a result, to the development of urolithiasis.

This happens due to metabolic disorders, unbalanced nutrition.

The precipitation of urates occurs when the body is dehydrated (for example, during the heat and insufficient drinking regime, due to profuse vomiting, diarrhea, etc.) or when meat food predominates in the diet.

Phosphates appear when eating foods rich in phosphorus (fish, sour milk, oatmeal, buckwheat, etc.).

Oxalates occur with any pH reaction, but with excess consumption of foods containing large amounts of oxalic acid.

Slime

The inner lining of the urinary system constantly secretes mucus. Normally, mucus is absent or found in small quantities.

Increased mucus secretion indicates insufficient hygiene of the genitals during the collection of the analysis or an inflammatory disease of the urinary system, but in the presence of other signs of pathology.

Urine analysis during pregnancy is an important laboratory diagnostic study. It is from the results of a general urine analysis during pregnancy that such a formidable pathology as late gestosis (preeclampsia) and pyelonephritis can be recognized, even if there are no clinical manifestations yet. We will consider the importance of a urinalysis in pregnancy.

Urine analysis - decoding in pregnant women

When decoding the result of urine analysis in the expectant mother, the following indicators are assessed:

The color and amount of urine. The amount should be at least 10 ml, with only the middle portion being collected. The color of urine should normally be straw yellow.
Acidity of urine depends on the nature of the diet of the pregnant woman. If the expectant mother prefers protein foods, then the urine reaction will be acidic. If a pregnant woman's diet contains a large amount of vegetables, fruits and dairy products, then the urine reaction will be alkaline. With a pronounced acidic reaction of urine in a pregnant woman, one can think about the development of early gestosis, which is accompanied by nausea and vomiting.
The most important indicator of urinalysis is the determination proteinuria... Normally, pregnant women should not have protein in their urine. The appearance of protein in the urine above 0.033 mg indicates kidney damage. This pathology is characteristic of the second half of pregnancy and is called late gestosis (preeclampsia). In such cases, the appearance of protein in the urine is combined with an increase in blood pressure and peripheral edema. If the clinical symptoms of preeclampsia progress, then this is the basis for hospitalization of the pregnant woman in an obstetric hospital. In severe cases, a woman must be delivered by caesarean section in order to save the life of the mother and her baby.
Leukocytes in the urine of a pregnant woman, from 0 to 5 in the field of view can be present. An increase in the number of leukocytes in the general analysis may indicate an inflammatory disease of the urinary system. The most common cause of leukocyturia is pyelonephritis.
Another important indicator of a general urine test during pregnancy is the appearance of bacteria. Bacteriuria is another confirmation of acute pyelonephritis in the expectant mother. Leukocyturia and bacteriuria can be accompanied by back pain and fever up to 39 °.
Impurity of salts in urine(urates, phosphates and oxalates) normally in a pregnant woman should be reduced, since most of it goes to the formation of the baby's skeleton. An increase in these compounds during pregnancy gives reason to suspect a pathology of the urinary system.
The appearance of glucose in the general analysis of urine may indicate gestational diabetes mellitus.
Ketone bodies should not be normal. Their appearance in the analysis of urine is a confirmation of early preeclampsia or diabetes mellitus of a pregnant woman.
Squamous cells and casts may be present in urine analysis in a single amount. Their increase may indicate the pathology of the urinary system.
Hematuria- this is an increase in the urine analysis of the number of erythrocytes above normal (0-4 in the field of view).

What if I get poor urine test results in pregnant women?

Poor urinalysis during pregnancy is the basis for a more extensive study. First, you should find out if the woman collected the morning urine correctly and schedule her a second analysis. If necessary, a urine test is prescribed according to Zimnitsky and Nechiporenko. To confirm or refute the diagnosis, an ultrasound examination of the kidneys is prescribed.

How to donate urine during pregnancy?

Morning urine should be collected for analysis. First, it is necessary to carry out a hygienic treatment of the external genital organs, then collect the middle portion of urine in a sterile container. The analysis should be delivered to the laboratory no later than 2.5 hours after receipt.

Thus, we saw that urine analysis during pregnancy is an important screening study that allows us to identify such formidable pathologies as gestosis, diabetes mellitus and inflammation of the kidneys and urinary tract.

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THREE IMPORTANT TABLES !!!
SAVE YOURSELF always come in handy!

A very interesting activity for young parents is the study of the child's analyzes, with their interpretation according to the norms given in the form. Dear, these are norms, firstly, for adults, and in children, normal indicators sometimes differ very much. And secondly, the forms printed a hundred years ago under Tsar Pea and since then have not been edited. Therefore, before dragging your obstinate child through all sorts of doctors, let's figure out if there is any pathology in the analyzes.

See our tables and their transcripts!

Urine analysis - what to look for and decoding: Urine analysis in children. How to collect, what to look for

Urine is an aqueous solution of electrolytes and organic matter. The main component of urine is water (92-99%), in which about a thousand different components are dissolved, many of which have not yet been fully characterized. Every day, approximately 50 - 70 dry substances are removed from the body with urine, most of which are urea and sodium chloride. The composition of urine varies considerably, even in healthy children, so urinalysis is complicated and makes one be very careful in interpreting the results obtained.

The daily volume of urine and the concentration of certain components in it depends on the intensity of glomerular (in the glomeruli of the kidneys) filtration, the degree of tubular reabsorption and / or excretion.
Indications for the appointment of a urine test:

Diseases of the urinary system;
Screening examination during medical examinations;
Assessment of the course of the disease, monitoring the development of complications and the effectiveness of the treatment;
Persons who have had streptococcal infection (tonsillitis, scarlet fever) are recommended to pass a urine test 1-2 weeks after recovery.
Healthy children are encouraged to perform this test 1-2 times a year.
Urine collection rules

In order for the results of the analysis of urine to be reliable, it is necessary to collect it correctly. Only morning urine is suitable for analysis.

First, we prepare the container. Wash a small jar with a wide neck and dry it. You can also use special bags-urinals (put on the genitals, glued, put on a diaper on top), they are sold in the pharmacy.

The genitals of the child should be clean, the baby should be washed in preparation for collecting urine - do not overdo it, wash it as you usually do. Do not use potassium permanganate, herbal infusions, or other antiseptics.

It is quite difficult to catch the moment of urination in a child under one year old, but many parents know the signs by which one can determine that the child wants to write - the baby is worried, screams, or, conversely, freezes. It remains only to bring the urine bag under the stream. It is preferable to collect the middle portion of urine.

You cannot pour urine from the pot, no matter how well it is washed, it is better to put a clean container in the pot to collect urine. You cannot squeeze urine out of a diaper or diaper, or even sterile gauze - all this distorts the analysis results.

If the child does not want to "pass urine for analysis" in any way, stimulate him to urinate by stroking his abdomen clockwise, or by the noise of pouring water.

In older children, urine is collected in the same way as in adults: wash, collect the middle portion of urine in a clean, dry dish.

Decoding urine analysis

When conducting a general analysis, the amount of collected morning urine is of no practical importance (well, unless you bring 1 ml of course). The normal amount of urine excreted during the day is highly dependent on age. The amount of urine secreted during the day in children can be approximately calculated using the formula:
600 + 100 (A - 1) = ml of urine in 24 hours, where A is the number of years of the child.

Diuresis increases with the intake of large amounts of fluids, the consumption of foods that increase the excretion of urine (melon, watermelon), decreases with restriction of fluid intake, increased sweating, vomiting, diarrhea, and in premature babies. Oliguria or anuria in newborns can be suspected if dry diapers are present for 12 to 18 hours.

The main indicators studied in urine:

1. The clarity of urine is determined by examining the urine in transmitted light. Normal urine is clear. Turbid urine can be with pyelonephritis or cystitis when it contains a large amount of mucus, cells, bacteria and / or salts.

2. Color of urine. Normally, young children have straw-yellow urine. At an older age, it becomes amber yellow. Children with pyelonephritis may have a more intense color of urine because this condition often causes a decrease in urine volume due to fever, vomiting, loose stools, and increased sweating. The color of urine may change with certain medications and foods. Rhubarb gives urine a greenish tinge. When taking riboflavin (vitamin B2), the urine becomes intense yellow. The urine darkens on standing if the child receives nitrofuran drugs (furagin, furadonin, etc.).

3. Reaction of urine. In a healthy child, the normal reaction of urine is slightly acidic, and it can change depending on the nature of the food. An alkaline reaction is observed when eating plant foods, and an acidic reaction is observed when eating meat. A child's ability to excrete both acidic and alkaline urine can be a confirmation of the normal functioning of his kidneys. Acidic urine (pH 5.5) is often observed in acute diseases of various origins, and neutral and alkaline (pH 5.5) in urinary tract and kidney infections due to the decomposition of urea by bacteria with the formation of ammonia.

4. Relative density (specific gravity). The specific gravity is determined by the content of solutes in the urine, primarily salts and urea. Under normal conditions, the relative density of urine during the day varies from 1008 to 1025, depending on the nature of the food, the volume of fluid drunk and excreted, and the child's age. This indicator characterizes the work of the kidneys for the dilution and concentration of urine. In chronic pyelonephritis, the specific gravity of urine may remain low and monotonous during the day, which will indicate a violation of the kidneys.

5. Protein in urine (proteinuria). Healthy children do not have protein in urine when it is determined by conventional methods. Sensitive studies show that protein is excreted in the urine and in single portions its concentration is not more than 0.033 g / l. In a child with pyelonephritis, protein may be present in the urine, reflecting damage to kidney tissue (renal proteinuria). Protein can enter the urine from the mucous membranes of the urinary tract or vagina - this is extrarenal proteinuria.

6. Leukocytes in urine (leukocyturia, pyuria or pus in the urine). Pus in the urine comes from the bursting small pustules that form in the kidney or urinary tract during inflammation. It mainly consists of white blood cells - leukocytes. Leukocytes "eat" microbes (this process is called phagocytosis) and save a person. An increase in the number of leukocytes in the urine indicates an inflammatory process in the kidneys or urinary tract. In the urine of a healthy child, when examined in the field of view of a microscope, single leukocytes can be found.

The detection of more than 5-7 leukocytes in the urine in boys and 8-10 in girls may indicate an inflammatory process in the urinary tract and kidneys. However, leukocytes can enter the urine from the external genital organs, which is possible in boys with narrowing and inflammation of the foreskin (phimosis with balanoposthitis), and in girls with inflammation of the external genital organs (vulvovaginitis). Inflammation of the external genital organs is manifested by local redness, leucorrhoea and other secretions that stain linen. Suspicion of this process can be resolved by the doctor when examining the external genitalia. If necessary, a urologist is involved in the examination of boys (elimination of phimosis), and for girls, a gynecologist who conducts not only an examination, but also a special study (a smear from the vaginal mucosa) and treatment of vulvovaginitis. With prolonged leukocyturia, the doctor also excludes renal and urinary tract tuberculosis.

7. Erythrocytes (red blood cells). Erythrocytes in the urine of a healthy child are absent or are found in a single number (1-2 in the field of view of the microscope). When red blood cells appear in the urine in excess of the norm, they speak of "hematuria" (blood in the urine). The term "gross hematuria" is used when blood is secreted in such an amount that the color of urine changes, it becomes dark red, the color of "meat slops" or "strong coffee". With "microhematuria", the color of urine does not change, and erythrocytes are detected by examining urine under a microscope. More than 100 congenital and acquired diseases can cause hematuria. Pyelonephritis, cystitis and reflux are on this list. Parents can help the doctor decipher the reasons that change the color of urine, since some food plants (beets, blueberries, etc.) or medications can stain it.

8. Cylinders in urine. The cylinders are casts of the renal tubules, the base of which is coagulated protein, so they appear in the urine with protein. Another condition for the formation of cylinders is the presence of an acidic urine reaction. They do not form in alkaline urine or dissolve quickly.

9. Salts. By the presence of salts in the general analysis of urine, one can judge its colloidal state, acidity and other properties. Depending on the acidity of urine, various salts can precipitate: in an acidic medium - uric acid, uric acid and calcium phosphate, calcium sulfate, calcium oxalate; in alkaline urine - triple phosphates, ammonium urate, amorphous phosphates, calcium carbonate and calcium oxalate. The amount of excreted salts can be determined only in daily urine. Uric acid precipitate is observed with excessive consumption of meat, strenuous physical exertion, fever, fasting, or taking hormones (prednisone).

Oxalates are present in the urine of children who eat foods high in oxalic acid - coffee, tea, nuts, strawberries, black currants, spinach, rhubarb, lettuce. Oxalate crystals can appear with prolonged standing of urine. Triple phosphates and amorphous phosphates are often found in urine sediment in pyelonephritis and cystitis. For this reason, the presence of salts in the urine does not allow the conclusion about the violation of salt metabolism.

The doctor, not the parents, should be responsible for decoding the urine test.

Clinical blood test in a child. What to look for and decryption:

Hemoglobin (Hb) is a protein that transports oxygen to tissues and carbon dioxide to the lungs.

Red blood cells (RBC - Red Blood Cells) are the main blood cells, "containers" of hemoglobin. The size of the containers is determined by the "Average amount of hemoglobin in one erythrocyte" parameter. Color indicator - the ratio of the obtained values of the amount of hemoglobin and erythrocytes to normal.

Hematocrit (Hct, PCV - Packed Cell Volume) - characterizes the ratio of plasma volumes and formed elements (blood density)

Reticulocytes - young erythrocytes are always present in the blood, the amount depends on the body's need for new erythrocytes.

Platelets - the main cells of blood coagulation, are not of interest in the treatment of acute respiratory infections.

Thickening of the blood (lack of fluid) is manifested by an increase in hematocrit and the amount of hemoglobin in the blood.

Leukocytes (WBC - White Blood Cells) are uniform blood cells that represent the immune system. The study of leukocytes allows you to understand the cause of the disease (bacterial, viral or allergic)

An important feature of the child's body is that the number of leukocytes in a child is, on average, much higher than that of an adult (since the immune system is just being formed).

Leukocytosis - an increase in the level of leukocytes above normal. It occurs during acute (especially bacterial) infections, purulent inflammatory processes, oxygen deficiency, etc.

Leukopenia - a decrease in the level of leukocytes below normal. It occurs with viral infections, with severe toxic and infectious conditions, accompanied by bone marrow suppression, with some bacterial diseases, radiation sickness, etc.

Leukocytes are divided into the following 9 types:

Neutrophils (myelocytes, metamyelocytes, stab, segmented) - 4 types;

Eosinophils;

Basophils;

Lymphocytes;

Monocytes;

Plasma cells.

The ratio of different types of leukocytes (in%) forms a leukocyte formula.

Neutrophils are especially active against bacteria. The more pronounced the bacterial inflammatory process, the greater their ratio in the formula. Matured neutrophils are called. segmented (a kind of special forces), immature - stab, young - metamyelocytes, and the smallest - myelocytes.

The more active the fight in bacteria, the more stab neutrophils in the blood ("all to the front"). Metamyelocytes and myelocytes appear only in the most critical cases, when the body is struggling with its last strength.

Basophils - have nothing to do with acute respiratory infections (normally no more than 1%)

Lymphocytes - participate in immune, are responsible for general and local immunity (detection, recognition and destruction of antigens, antibody synthesis, etc.). The main and most common type of leukocyte in the blood. Lymphocytosis is primarily a symptom of a viral infection.

Monocytes - are engaged in phagocytosis (absorption and digestion of bacteria, dead cells, etc.). Lives in the blood for about 30 hours, after which it passes into tissues, where it matures to a macrophage (from ancient Greek - a big devourer).

Plasma cells - are responsible for the formation of antibodies (normally 1 in 200-400 leukocytes in children, absent in adults). The number increases primarily with viral infections with damage to lymphoid tissue (infectious mononucleosis, measles, rubella, chickenpox, etc.)

The sedimentation rate of erythrocytes, ESR - the size of the column of settled erythrocytes per hour (mm / h). An increase in ESR indicates an inflammatory process in the body (in children, it is normal from 2 to 10 mm / h)

How is a complete blood count performed?
A general blood test does not require special preparation. As a rule, the analysis is carried out in the morning, on an empty stomach (or 2 hours after a meal). Blood for general analysis is taken from a finger (usually from a ring finger) using a special sterile instrument - a scarifier. With a quick movement of the hand, the doctor makes a small puncture of the skin of the finger, from which a drop of blood soon appears. The blood is collected with a small pipette into a vessel that resembles a thin tube. Less commonly, blood for a general blood test is taken from a vein.

Biochemical analysis of blood in children. What to look for, decoding.

As a rule, the decoding of a child's biochemical blood test includes eight main indicators.
blood sugar (glucose) and calcium levels;
kidney function test;
balance of electrolytes and body fluids.
When this analysis is done

This set of indicators is often determined to assess the general condition of the body or for diagnostic purposes. It should also be performed in patients admitted to the emergency department, as it allows you to quickly get information about the possible cause of the problem and provide adequate assistance.

Decoding of the biochemical blood test of the child:

Glucose is a sugar that constantly circulates in the blood and is needed to provide the body with energy. Deviations of this indicator from the norm indicate the presence of diabetes or hypoglycemia (low sugar level).

Calcium - plays an important role in the processes of muscle contraction, transmission of nerve impulses, hormone secretion. A decrease or increase in calcium levels may indicate hormonal imbalances or problems with the liver, bone, or pancreas.

Sodium, potassium, carbonates and chlorides (electrolytes) help maintain the fluid balance in organisms, as well as the acid-base environment. They are important for the regulation of heart rate, muscle and brain function. Deviation of electrolyte levels from the norm occurs with the development of heart disease, kidney disease, or severe dehydration.

Urea in the blood and creatinine are end products of metabolism and are excreted from the body through the kidneys. An increase in their concentration is a signal of possible problems in the functioning of the kidneys.
Preparation for analysis

In case of urgent need, the analysis of basic biochemical parameters can be performed without preliminary preparation. But in order for the results to give more objective information, the child should refrain from eating and drinking for 8-12 hours before the analysis. When going to the doctor, choose clothes for your child that will not obstruct access to the ulnar vein.
Procedure

Blood sampling is carried out from the cubital vein by trained health professionals. In infants, blood for biochemical analysis is taken from the heel using a thin needle. The injection site of the needle is treated with an antiseptic. The section of the arm above the vein is compressed in order to increase the pressure in the vein and make it full. Then a needle is inserted into the vein, through which the blood enters a special vessel or test tube.

At the end of the blood collection procedure, the pressure bandage is removed. The needle is removed after the required volume of blood has been collected. A piece of cotton wool is applied to the puncture site in order to stop the bleeding. The procedure takes no more than a few minutes.

Taking blood from a vein causes temporary inconvenience, the child will feel an unpleasant injection, but there is no strong pain during this procedure. Most children are afraid of this procedure. Help them. Explain the course of the analysis and its purpose, tell about why the doctor performs this analysis and how, after undergoing the correct treatment, the child's well-being will improve. Let him ask any questions that interest him to the medical staff. Help your child relax during the procedure. The tension makes it more painful. Take your attention away from the needle, especially when inserting it into a vein.

In modern medical institutions, a biochemical blood test is performed using special equipment. It allows you to get the result within an hour, but usually there is no need for such a rush and you will have to wait about a day. If deviations from the norm in the analysis results are detected, a re-examination is prescribed.

In general, the analysis of blood biochemical parameters is a safe procedure, but in some cases minor complications may arise:
fainting or dizziness;
hematomas (accumulations of blood under the skin in the area of a vein puncture).

Order of tables:
1. Clinical blood test in children
2. The main indicators of the biochemical blood test in children
3. The main indicators of biochemical analysis of urine in children

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Urine analysis is normal

Urinary tract infections are the second most common after respiratory diseases, so people very often have to deal with urine testing. So what should a urine test be like and how to read it correctly?

General urine analysis

Below are the norms (in the table):

Indicators

4.8 (slightly acidic) to 7.5 (slightly alkaline)

Relative density

Not more than 0.033 g in 1 liter

The presence of glucose

Women: 0-3 p.p.

Men: 0-1 in sp.

Leukocytes

Women: 0-6 in sp.

Men: 0-3 in sp.

The presence of epithelial cells

Urine analysis, deciphering the norm

The color of urine can range from light to rich shades of yellow. Darkening of urine can occur with a number of diseases. It can be caused by the presence of blood in the urine (for example, with glomerulonephritis), or an increase in various pigments (with various jaundices, hereditary diseases). The color may change after taking certain medications.

Urine is normally clear and odorless. The relative density can change with insufficient or excessive fluid intake, but also its change may indicate in favor of some diseases (for example, diabetes mellitus).

Normally, the urine lacks glucose, protein, and also there are no ketone bodies, bilirubin. The presence of protein can indicate glomerulonephritis, amyloidosis, various diseases of the connective tissue.

Ketone bodies can occur with diabetes mellitus, as well as with acetone syndrome in children (often against the background of viral infections, gross violations of diets). The presence of bilirubin in the urine most often signals a liver problem.

Urine analysis, decoding the norm of leukocytes

The rate of leukocytes differs in men and women. The norm of urine analysis in women suggests up to 6 leukocytes (Leu), while in men this figure is 3. An increase in leukocytes above the norm most often indicates inflammation in the urinary tract (pyelonephritis, cystitis, urethritis).

Urine analysis erythrocytes norm

For women, the norm of erythrocytes is up to 3, for men - up to 1 (in the field of view). If their number is higher than this, then this indicates the presence of blood in the urine. It is most commonly caused by kidney stones and tumors.

The presence of salts (most often oxalates) in the urine indicates that either a person has kidney stones, or there is a predisposition to their formation.

The presence of cylinders in the urine also indicates various disorders. But it is precisely the presence of hyaline cylinders that can be observed after normal physical exertion.

Contraction urine analysis

The analysis can be written in the form of abbreviations, and in this case, its decoding is necessary.

These designations may include:

S.G urine density,
LEU - leukocytes.

Biochemical urine analysis (norm)

Conducting a biochemical analysis is necessary in some cases in the presence of deviations in the general clinical analysis of urine to clarify the violations. The main biochemical indicators are glucose (normally up to 0.05 g per 1 liter), amylase (normally from 10 to 1240 units), sodium (normally within 100-260 mmol), potassium (normally from 39.4 to 82 mmol). Important indicators of kidney function are creatinine (normally for women it ranges from 0.48 to 1.44 g / l, for men a little more - from 0.6 to 1.6 g per 1 liter) and urea (normally 333 - 587 mmol) ...

Urine analysis (normal) in children

In children, the norms of urinalysis results almost coincide with those of an adult. But at the same time, the specific gravity of a child's urine is lower than that of an adult, and these indicators change from smaller to larger with the growth of the child, reaching the norm of an adult by the age of 12. Thus, a general analysis of a newborn and an infant (their norm) may be almost indistinguishable from the analysis of a person of age.

Urine analysis is normal according to Nechiporenko

Analysis according to Nechiporenko is performed if specific deviations were found in the general clinical analysis. Normally, the indicators should be as follows:

The number of leukocytes in 1 ml is not more than 2 thousand;
the number of erythrocytes in 1 ml is not more than 1 thousand;
the number of cylinders in 1 ml is not more than 20.

Urine analysis (normal) according to Zimnitsky

Analysis according to Zimnitsky shows the total amount of urine that is excreted throughout the day and changes in its specific gravity. Normally, there should be the following regularities: the amount of all daytime urine should be slightly more than the amount at night, and the specific gravity should range from 1010-1025 during the day to 1035 at night.

Urinalysis (normal) during pregnancy

The norms of all urine analyzes in pregnant women correspond to the general norms of urine analyzes in a woman. However, an increase in some indicators may indicate other diseases that occur exclusively in pregnant women, toxicosis, nephropathy of pregnant women, preeclampsia.

Urine analysis for diastasis is normal

This urine indicator may indirectly indicate pancreatitis, liver disease and other inflammatory diseases. Normally, it can vary in the range of 16-64 units.

Interesting

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Urology: General urine analysis (interpretation of indicators, norm)

Deciphering the indicators of the general analysis of urine

General urine analysis refers to the mandatory diagnostic procedures that are prescribed to all patients who visit a healthcare facility.

Here we will tell you what urine indicators are measured in a general urine analysis, and what diseases are indicated by certain deviations of these indicators from the norm. And also about how to correctly collect urine for general analysis, daily urine analysis and for urine analysis according to Nechiporenko.

In the general analysis of urine, such parameters are investigated as: specific gravity (relative density), color, transparency, odor, pH (acidity), protein content, glucose content, content of ketone bodies and bile pigments and some other indicators.

The results of urine analysis are given to the patient in the form of a table with incomprehensible letters, which can only be read by a specialist. Below is a decoding of those very "incomprehensible letters", as well as the norms and possible deviations for individual indicators.

Deciphering the indicators of the general analysis of urine

BLd - erythrocytes,

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Urine tests: the norm in adults, decoding of indicators

Physical indicators of the general analysis of urine

First of all, the laboratory measures the physical parameters of urine. These include: color, odor, definition of transparency, density and ph. For the convenience of all procedures, urine is stored on a special table with various devices for determining the physical properties. There are special standards by which the laboratory assistant can easily see the deviations of a particular urine test.

To determine the density, a special device is used - an urometer. It is dipped into a urine tube and readings are easy. The norm for the specific gravity in adults is 1010-1025 g / l. At the same time, the indicators of healthy men and women do not differ.

The laboratory assistant determines the color of urine by eye. The form indicates: straw yellow, brown, red, pink, light yellow. It is the first option that is considered the norm. The change in the color of urine can be affected by taking multivitamins, medications, as well as menstruation.

The smell is determined by sniffing. For example, with diabetes mellitus, you can feel the unpleasant smell of acetone.

The clarity of the urine analysis is determined visually. Sometimes, during long-term storage, a precipitate of salts can form, in which case it can be difficult to decipher this indicator. The turbidity of the urine is usually due to protein, which is considered abnormal and is an indicator of kidney disease.

Ph urine analyzes are determined using indicator paper. The strip is placed in a test tube and the color is compared with a special standard. An acid reaction is the norm for this type of analysis. The laboratory assistant carefully notes all deviations in the form so that the doctor can immediately see a bad urine test and prescribe treatment to the patient on time.

Determination of organic matter in urine

When all the physical properties of urine are determined, the indicators are entered into the form, it is time for an organic analysis. Usually, laboratory assistants are required to determine only glucose and protein, but the doctor may prescribe an extended urine test and indicate bilirubin, bile acids, indican.

All of these substances should not be present in the urine of a healthy person. Therefore, the laboratory assistant first of all conducts a qualitative analysis of urine using an indicator strip. If the standard shows that glucose or protein is available, then it is the turn of the qualitative determination of these indicators. It is worth remembering that there may be traces of protein in the urine - this is the norm, because this phenomenon is usually associated with human nutrition.

The appearance of protein in the urine can be triggered by a bacterial infection of the genitourinary system, increased physical and emotional stress, sudden changes in the temperature of the environment in which the person is. The doctor must correctly read all the indicators in order to diagnose the disease.

After carrying out a qualitative and quantitative indicator of urine analysis, the laboratory assistant proceeds to microscopy of the sediment. This is the final stage of the research.

Study of urinary sediment of urine

To obtain a precipitate, the laboratory assistant centrifuges the liquid. This procedure is very quick and does not require any human effort or intervention. The resulting precipitate is placed on a glass slide and carefully examined under a microscope.

Standard analysis includes determining and quantifying:

epithelium;

101analiz.ru

Table for decoding the general analysis of urine in adults

Due to the ease of implementation and the significant information content of the results, urinalysis has become one of the most common types of diagnostic studies. Urine is a physiological fluid formed by the filtration of blood in the kidneys as a result of metabolism in the body. For the most part (about 96%) it consists of water, and the rest is the metabolic products dissolved in it (uric acid and urea, mineral salts, etc.). The composition of urine is very sensitive to changes in the state of the body, therefore, based on its analysis, various diseases can be diagnosed. A general urine test is prescribed for suspected violations of the genitourinary system, as planned preventive examinations and to monitor the effectiveness of therapy in the recovery process.

Decoding a general urine analysis involves a description of urine according to the following indicators: transparency, color, specific gravity and acidity. Then, the presence of specific substances in the urine, such as protein, glucose, bile pigments, ketone bodies, hemoglobin, inorganic substances, blood cells (leukocytes, erythrocytes, etc.), as well as cells found in the urinary tract (epithelium and its derivatives - cylinders). The norms for the content of components in the decoding of the general analysis of urine differ depending on the age of the patient. The subject of the review of this article will be the decoding of the general analysis of urine in adults.

The reliability of decoding a general urine test depends on the conditions for its delivery, so take seriously the preparation and implementation of the following simple rules. On the eve of the analysis, stop eating foods that can change the color of urine (these include beets, rhubarb), as well as drugs of a similar effect (for example, aspirin). If you have been taking diuretics, take a break. When collecting urine, the external genitalia must be clean enough to require a thorough toilet. Collect only the middle portion of urine after a night's sleep. It is unacceptable for women to take a general urine test during menstruation. To transport urine, use special medical containers, the material of which does not enter into chemical reactions with urine, and the container itself is sterile. The method of closure and the tightness of the container are also of great importance. Long-term storage of urine can distort its physical properties, promotes the multiplication of bacteria in it and the decomposition of salt sediments, therefore, the collected material should be delivered to the laboratory as soon as possible.

Table for decoding the general analysis of urine

The decoding of a general urine test in adults can be summarized in the following table.

Indicator name

Urine color

The urine of a healthy person has a yellow or straw color of varying saturation from almost transparent to amber.

A change in the color indicator in decoding a general urine test in adults may indicate various diseases. In some cases, the urine may be stained with traces of blood. Dark urine is indicative of liver dysfunction (cirrhosis, hepatitis) and for blockage of the bile ducts (with a greenish tinge).

All shades of yellow or straw are acceptable

Clarity of urine

In the normal state of the body, urine should be clear. If mucus, bacteria, fats, protein or minerals are found in it, the urine becomes cloudy in accordance with the amount of unwanted impurities.

Completely transparent

Urine smell

The urine of a healthy person has a specific, unsharp odor. A change in the characteristic odor clearly indicates that there are malfunctions in the body. For example, with infectious diseases of the bladder, a persistent smell of ammonia or even rot appears, and with diabetes mellitus, the smell of rotting apples.

Neutral, mild

Urine reaction (pH)

This indicator in the table for decoding the general analysis of urine characterizes the balance of acids and alkalis. The acidity of urine is determined by the composition of the food, the volume of water drunk and the general condition of the body. Usually urine has a slightly acidic reaction. An increase in urine acidity indicates the presence of diabetes mellitus and chronic kidney disease. During the course of infectious diseases of the genitourinary tract, the acidity of urine, on the contrary, decreases.

Weakly acidic reaction with pH<7

Relative density or specific gravity of urine

The density of urine in the decoding of the general analysis for adults varies widely depending on the amount of fluid drunk, the time of day, and the dynamics of kidney function. In a healthy person, it ranges from 1.008 to 1.024.

Ranges from 1.008 to 1.024 in the morning portion

Glucose, protein, bilirubin, ketone bodies

Normal - absent

No more than two or three in the field of view.

Leukocytes

Allowed about six to eight cells in the field of view

Epithelial cells

The appearance of the epithelium in the decoding of the general analysis of urine indicates the detachment of the tissues lining the genitourinary system. If there are few epithelial cells, then there is no cause for concern.

Zero to ten in sight

Granular (formed by erythrocytes), epithelial (formed by epithelial cells), leukocyte (formed by leukocyte cells) casts appear in the urine due to inflammation of the kidneys. Fatty casts are indicative of chronic glomerulonephritis. In the most common cases, an increase in the number of cylinders indicates inflammatory processes in the kidneys.

Allowed in small quantities

Little or no presence

Decoding a general urine test during pregnancy

Urinalysis is widely used to monitor the health of expectant mothers. Deciphering the general analysis of urine during pregnancy allows you to analyze the physiological state, taking into account its specifics. During pregnancy, the kidneys are particularly stressed, and the well-being of the mother and child largely depends on their functioning.

During pregnancy, this type of laboratory study is performed quite often: during the first and second trimesters - monthly, and in the third every 2 months. A general urine test is indispensable for assessing the functioning of the kidneys, as well as identifying special diabetes mellitus in pregnant women.

The table for decoding the general analysis of urine during pregnancy takes the following form:

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General urine analysis during pregnancy

After registering for pregnancy, before each visit to the gynecologist, a woman must donate urine for a clinical study, the so-called general urine analysis. Why do you need to do this?

Urine is formed in the kidneys after the blood is filtered. With urine, metabolic products, salts, excess water, as well as some enzymes, hormones and vitamins are excreted from the body. By analyzing urine, one can judge the functioning of the kidneys and other organs, the normal functioning of which is undoubtedly very important during pregnancy.

During pregnancy, a general urine test is performed in the same way as usual. The analysis determines the physical properties and chemical composition of urine, as well as its sediment.

By studying the physical properties of urine, assess its quantity, color, density and transparency. When studying the chemical composition of urine, its pH is determined, as well as the presence or absence of such chemical compounds as protein, glucose, urobilinogen, bilirubin, ketone bodies. Microscopic examination of the sediment allows you to determine if the urine contains erythrocytes, epithelium, leukocytes, casts, salts and bacteria.

The decoding of the general analysis of urine during pregnancy is carried out according to all of the above indicators. Normally, a pregnant woman has the following urinalysis indicators:

amount - 150-250 ml (whole morning portion);
color - from straw to deep yellow;
transparency is absolute;
pH - from 5 to 7;
protein - absent or less than 0.075 g / l;
glucose, bilirubin, ketone bodies (ketones), bacteria - absent;
urobilinogen - traces;
epithelium - absent or single cells of transitional or squamous epithelium;
leukocytes - absent or up to 5;
cylinders - absent or single hyaline;
salts are single amorphous urates and oxalates.

If the indicators deviate from the norm, then various disturbances in the functioning of the body of a pregnant woman are assumed. Some of the most common deviations from the norm will be considered (deciphered) in the next article.

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Clinical analysis of urine during pregnancy: norms and interpretation | Zaletela.NET

How to properly collect urine for analysis?

It is necessary to collect the middle portion of the morning (immediately after sleep) urine in a special sterile container for analyzes with a plastic cap.

The last sexual intercourse must be at least 12 hours before the collection of the urine sample.

The collected urine must be delivered to the laboratory within 1-1.5 hours. On the test jar, legibly indicate your last name, initials, date of test collection and time.

Decoding urine analysis during pregnancy

Laboratory research of this biological fluid includes the determination of its organoleptic characteristics, physical and chemical properties, biochemical composition and sediment microscopy.

Norms of indicators of the general analysis of urine during pregnancy

Colour

A symptom of a disease is most often considered if the urine has a color:

strong tea ("beer" color) - pathology of the liver and gallbladder, for example, parenchymal (hepatic) jaundice or viral hepatitis;
pink-red (the color of "meat slops") - inflammation of the kidneys, for example, acute glomerulonephritis;
greenish-yellow ("lemon" color) - obstructive jaundice (ie gallstone disease), the presence or ingress of pus into the urinary system;
dark brown (dark brown) - hemolytic anemia;
whitish - the presence of a large amount of phosphates or lipids, for example, kidney lymphostasis, fatty degeneration of the kidneys;
milk - urinary tract infection, cystitis, pyelonephritis.

Transparency

Freshly collected, normal urine is ideally clear, possibly slightly cloudy, due to the presence of epithelium and mucus.

Pronounced turbidity of urine is caused by erythrocytes, leukocytes, bacteria, mucus, a significant amount of salts or epithelial cells, etc. Specific gravity

This indicator depends on the amount of substances dissolved in the urine and the water drunk during the day.

The relative density (or specific gravity) of the urine of a healthy person is 1 003-1035 g / l.

An increase in density occurs with dehydration, toxicosis, uncontrolled diabetes mellitus, glomerulonephritis, etc., and a decrease - with abundant drinking, nephritis, renal failure. pH

The reaction of urine in a healthy person with a balanced diet is slightly acidic (pH = 6.0 and>) or neutral (pH = 7.0).

An acidic environment is a good environment for the development of bacteria, so the presence of such an environment all the time is undesirable.

Kidney failure, urinary tract infections, and other diseases affect the rise in pH.

Diabetes mellitus, tuberculosis, fever, severe diarrhea and other ailments will affect the pH by lowering it. Protein

Normally, there is no protein in the urine, but during pregnancy, a slight increase to 0.033 g / l is allowed, which is caused by strong emotional experiences for the health of the fetus, possible overheating in the summer or hypothermia in the cold season, taking undenatured protein foods (raw eggs and homemade unboiled milk ), the presence of allergies at the time of the test, and indeed, a strong load on the kidneys.

Normally, sugar in the urine of a healthy person is absent or is found in insignificant amounts up to 0.083 mmol / l.

Detection of glucose (glucosuria) is observed in diabetes mellitus, renal and other types of diabetes. Bilirubin

Acetone is most commonly found in the urine of anemia or gestational diabetes during pregnancy. In such cases, a dropper and a special diet are prescribed by a doctor at the hospital. The main goal is to drink more alkaline mineral water (Borjomi, for example), exclude sweet, fatty foods, reduce protein intake, and vice versa, include more carbohydrate foods in the diet. Nitrite

They are not found in the urine of a healthy person. A positive result indicates the presence of an infection in the urinary tract. Hemoglobin

Normally, there is no hemoglobin in the urine. Usually, its presence indicates hemolytic anemia. Erythrocytes

In a healthy person, erythrocytes in the urine are either absent, or 1-2 cells are found in the field of view.

An increase in the number of red blood cells (hematuria) occurs in renal diseases and diseases of the urinary system. Leukocytes

To fight the causative agents of various diseases, the body produces leukocytes. Normally, a woman's urine contains 0-5 leukocytes per field of view.

An increased content of leukocytes (leukocyturia) always indicates inflammatory processes in the kidneys - pyelonephritis, urinary tract - cystitis, urethritis or genitals.

Women who neglect personal hygiene and other rules when taking an analysis get an erroneously positive result.

In the analysis of a healthy person, bacteria and fungi should be absent, their presence indicates an infection of the genitourinary system (cystitis, urethritis, candidiasis, etc.). Salt

Excessive salt content (urates, phosphates or oxalates) leads to the appearance of stones and, as a result, to the development of urolithiasis.

This happens due to metabolic disorders, unbalanced nutrition.

Phosphates appear when eating foods rich in phosphorus (fish, sour milk, oatmeal, buckwheat, etc.).

Oxalates occur with any pH reaction, but with excess consumption of foods containing large amounts of oxalic acid. Slime

The inner lining of the urinary system constantly secretes mucus. Normally, mucus is absent or found in small quantities.

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Content

Urine tests during pregnancy are necessary to monitor the state of a woman's vital organs and timely diagnose dangerous diseases. To assess the activity of the cardiovascular and urinary systems, a general clinical analysis, the method according to Zimnitsky and Nechiporenko, is used.

Objectives of urine testing during pregnancy

Urine tests during pregnancy are mainly aimed at determining such abnormalities as gestosis, gestational diabetes mellitus and pyelonephritis. These diseases most often complicate the course of pregnancy and require constant monitoring. also involves the use of urine for diagnosis.

The appearance of glucose, protein in the urine, bacteria, an increase in the number of leukocytes indicate the presence of pathology in a pregnant woman, which is not always associated with kidney disease. The urinary system reacts not only to kidney pathology, but also to changes in the functioning of the immune system, cardiovascular, endocrine system. That is why it is necessary to have a urine test so often during pregnancy.

In the second half of pregnancy, urine tests are performed every 2 weeks.

A screening method for identifying pathological changes in the body is a traditional general urine test. The analysis has the following goals:

screening for asymptomatic pathology;
diagnosis of diseases and borderline conditions during pregnancy;
monitoring the development of the disease;
tracking treatment results.

When collecting urine, women often notice its turbidity and discoloration. This is largely due to a change in the nutrition of the pregnant woman, taking medications, stagnant urine due to squeezing of the ureters by the uterus. You should not panic when you find flakes in the urine, after the study it will become clear what exactly caused them to appear. Most often, turbidity in healthy women is due to the presence of phosphates, squamous epithelium, mucus.

In the first trimester of pregnancy, acetone is most often found, indicating dehydration with toxicosis. In the second half of pregnancy, the risk of gestosis, diabetes mellitus, and urinary tract infections increases, so doctors carefully monitor the presence of protein, glucose, bacteria, leukocytes in the analysis. becomes the reason for a more detailed diagnosis.

Final diagnosis established on the basis of several urine tests, as well as additional studies (ultrasound, blood tests).

Types of urine tests and collection rules

The routine method of urine examination during pregnancy is a general clinical analysis. It is a screening test, and when unsatisfactory results are obtained, the doctor prescribes a more detailed study: analysis according to Zimnitsky, Nechiporenko, urine collection using a catheter.

General

A general urine test is considered one of the most common studies that are used in general clinical practice. A general urine test during pregnancy includes several successive stages of the study:

assessment of color and transparency (macroscopic properties);
assessment of physical and chemical properties;
microscopy of urine sediment.

Collection rules include several items.

For a general urinalysis, use the morning middle portion.
Urine should be collected in a clean and dry container, and it is not recommended to use utensils from under food and chemical products. Special containers for analysis can be purchased at the pharmacy. For a general study of urine, a clean container is sufficient; it is not necessary to purchase a sterile one. The optimal amount of urine for analysis is 50 ml, the minimum corresponds to 12 ml - this is the amount that is suitable for microscopy of the sediment.
The interval between collection and analysis should be no more than 2 hours.
Before collecting the analysis, two hygiene procedures are required: the first time with soap, the second with running water in order to wash off the soap.
Insert a cotton ball or small swab into the vagina to exclude vaginal discharge from the analysis. During pregnancy, spotting, abundant vaginal discharge are often noted, therefore, preventive measures should be taken to avoid distortion of the result.
Dinner should be light on the eve of the study. Do not increase or decrease the amount of fluid you drink. It is necessary to exclude the use of beets before passing a urine test.

It is necessary to inform the doctor about the medications taken, the presence of any symptoms indicating the pathology of the urinary system (increased urination, nocturnal diuresis, soreness, fever).

Vitamins taken during pregnancy color the urine bright yellow or orange.

According to Nechiporenko

Urine analysis according to Nechiporenko during pregnancy is intended to detect acute and chronic infectious and inflammatory diseases of the urinary tract. The indication for the analysis according to Nechiporenko is a poor result of a general clinical analysis of urine, namely, an increase in the number of leukocytes, epithelium, erythrocytes, the presence of bacteria, mucus.

The purpose of the analysis is to accurately determine the number of leukocytes, erythrocytes, cylinders.

Collection rules:

carry out hygiene procedures for the external genital organs;
exclude the entry of vaginal discharge into the analysis using a tampon;
collect a medium portion.

On the eve of the study, it is necessary to exclude coloring foods (beets) from the diet, reduce the consumption of sweets, coffee, meat, milk, and acidic foods. The amount of vegetables and mineral water should be moderate to avoid alkalization of urine.

With a catheter

Often during pregnancy, urine must be collected using a catheter. As a rule, for the purpose of analyzing urine, a catheter is used in case of unsatisfactory results of urine tests, in particular, determining the infectious process (increased leukocytes, bacteria). In such situations, specialists need to determine the source of bacteriuria and confirm its urinary or renal origin.

Often, genital infections in women provide leukocyturia, bacteriuria. In such cases, it becomes difficult to diagnose, and doctors resort to bladder catheterization. In this way, it is possible to reliably determine the composition of urine.

To drain urine with a catheter disposable, soft polyurethane tubes are used.

The introduction is carried out by a doctor, the area of the external genital organs is preliminarily treated with an antiseptic. The catheter is inserted slowly and carefully. Catheterization is accompanied by unpleasant sensations, sometimes painful, but bearable.

Contraindications to catheterization are:

trauma to the urethra;
acute urethral infections;
cystitis;
unconsciousness.

After such an analysis during pregnancy, the act of urination often becomes unpleasant, soreness and drops of blood appear. This is due to minor trauma to the urethral mucosa. In such situations, a woman is prescribed herbal uroantiseptics (Kanefron, Urolesan) and No-shpa to relieve spasm. The drugs do their job in 2-3 days and are safe during pregnancy.

Urine analysis performed using a catheter allows the most accurate diagnosis of chronic cystitis, pyelonephritis.

Analysis according to Zimnitsky

A study according to Zimnitsky is prescribed during pregnancy in case of suspicion of fluid retention, cardiac, renal pathology.

The purpose of the analysis is:

determination of the relative density and volume in eight three-hour portions;
determine the ratio of daytime diuresis to nighttime.

the ratio of daytime diuresis to nighttime is 3: 1 - 4: 1;
the intervals of density fluctuations should be at least 8-12 units;
total amount - 1.5-2 liters;
the ratio of drunk to allocated is 65-80%.

Collection rules:

on the eve of the study, limit fluid intake to 2 liters per day;
urine is collected in a day;
the morning portion is not collected, the collection begins from the moment of the second urination and continues until the same time the next day;
for 3 hours, a woman urinates in the same clean container, while collecting all the urine;
indicate the time on containers (time interval);
urine for analysis should not be mixed;
a total of 8 containers are used.

After collecting urine, the following indicators are determined:

volume in each of 8 containers;
specific gravity of each portion;
the total amount, comparing it with the volume of liquid drunk;
the volume of daily urine output (up to 18.00);
the volume of nocturnal diuresis (from 18.00).

Thanks to such a study during pregnancy, it is possible to determine:

diabetes;
heart failure;
renal failure;
glomerulonephritis;
to confirm edema, which is often recorded with arterial hypertension, gestosis.

Decoding:

density less than 1010 g / l - renal, heart failure, acute pyelonephritis, diabetes insipidus;
density above 1035 g / l - glomerulonephritis, diabetes mellitus during pregnancy, anemia due to hemolysis, preeclampsia;
decrease in daily urine output less than 1.5 liters - insufficiency of cardiac and renal function, edema, excessive sweating in pathologies of the thyroid gland, insufficient fluid intake, glomerulo or pyelonephritis;
secretion of too much urine - chronic renal failure, diabetes insipidus, drinking too much fluids;
a decrease in the ratio of drunk to allocated less than 65% confirms edema and preeclampsia during pregnancy;
increased nocturnal urine output during pregnancy - thyroid pathology, severe liver, heart and kidney diseases.

The technique is designed to assess the excretory and concentration function of the kidneys. In addition to the analysis according to Zimnitsky, women are often prescribed a study to detect hidden edema.

Norms and interpretation of the analysis in pregnant women

After delivery of urine to the laboratory, experts determine the indicators.

The color and transparency are the first to figure out.
Physicochemical properties, which include specific gravity, pH, the presence of protein molecules, albumin, glucose, ketone bodies, hemoglobin, bilirubin, urobilinogen, leukocytes, nitrites.
Sediment microscopy, which implies the determination of organized components (leukocytes, erythrocytes, epithelial cells, cylinders of various types, bacteria, helminth eggs, fungi, protozoa) and unorganized (salts, crystals).

An obligatory step in the general analysis of urine is a microscopic examination of the sediment. The urine sample is centrifuged and a sediment is obtained, which is then examined under a microscope.

Normal urine during pregnancy has the following indicators:

completely transparent;
is slightly yellow, yellow or close to amber;
the relative density varies from 1003 to 1040, but the specific gravity of the morning portion should not be less than 1020. The indicator for healthy women ranges from 1015-1025;
protein, glucose, mucus, bacteria, cylinders, ketones (acetone), nitrites should be absent (have values that are not determined by standard test systems);
the amount of urobilinogen should not exceed 17 μmol / l;
the number of leukocytes in the field of view should not exceed 4-6 pieces;
the number of squamous epithelial cells should not exceed 5 pieces, transitional and renal epithelium in urine during pregnancy are absent;
the test for diastasis is negative;
salts should not be found in urine.

Color and transparency

By the color of urine in the analysis during pregnancy, pathology can be suspected.

Orange, green colors indicate the presence of bile pigments and liver pathology.
Red and brown color in urine during pregnancy indicates kidney and urinary tract diseases. Red urine indicates the presence of unchanged erythrocytes in it, which penetrate into the analysis when the urethra, bladder, ureters, pelvis are damaged and most often appear with acute inflammation, movement of stones, damage to the mucous membrane. The brown color of urine analysis during pregnancy indicates the presence of altered erythrocytes and hemoglobin, the so-called color of meat slops, which is often recorded with glomerulonephritis. Porphyrins can cause red color.

Changes in transparency can be recorded in the form of turbidity due to the presence of:

a large number of leukocytes;
increased levels of epithelial cells;
bacteria;
mucus;
fat drops;
salts - urates, phosphates, oxalates.

Urine during pregnancy can be cloudy when stored at low temperatures. In addition, prolonged standing of the analysis in the container leads to the multiplication of bacteria, which also leads to turbidity and a decrease in transparency.

Slight turbidity in urine analysis during pregnancy observed normally with a slight increase in the level of epithelial squamous cells and in the presence of mucus.

Density or specific gravity

Specific gravity or relative density of urine means the ratio of a certain volume of fluid excreted by the kidneys to the same volume of water. An increase in this indicator during pregnancy is observed with an increase in the content in the urine of various substances dissolved in it, it decreases steadily at a level below 1010 with renal failure.

Normally, the relative density is determined by the content of creatinine, sodium, chlorine, urea. The specific gravity rate depends on the drinking regime and is 1015-1025 units.

An increase in the specific gravity in the analysis during pregnancy is possible with an increase in protein, glucose, ketones. Thus, an increase in the specific gravity may indicate such pathologies during pregnancy:

gestational diabetes mellitus;
change in the secretion of antidiuretic hormone;
diseases associated with an increase in the content of protein in the urine - gestosis, pyelonephritis, glomerulonephritis, acute inflammatory processes.

A decrease in the relative density is recorded at:

kidney disease during pregnancy, accompanied by glomerular necrosis;
diabetes insipidus;
insufficient protein intake (vegan and vegetarianism, unbalanced diet);
drinking plenty of fluids;
taking diuretics.

Reaction

The reaction of urine during pregnancy should remain the same as in its absence.

Normal urine during pregnancy has a pH of 4.8 - 7.5, which means a weakly acidic reaction of the analysis.

Too acidic urine, when its reaction is 4.5 U or less, indicates the possible presence of metabolic acidosis. During pregnancy, such an analysis is recorded with toxicosis, gestosis, gestational diabetes mellitus. In addition, if the woman is not drinking enough fluids, the urine may be acidic.

The alkaline reaction of urine during pregnancy, when the pH is more than 8 IU, can become a marker of urinary tract infection, since bacteria are able to transform urea into ammonia.

Prolonged standing of urine can lead to an alkaline reaction. High pH values can increase urinary protein levels.

Protein

Normally, the glomeruli of the kidneys cannot filter protein molecules into the urine. This means that urine during pregnancy cannot contain protein. Modern laboratories also determine the amount of albumin in urine, which can show gestational diabetes mellitus during early pregnancy, when proteinuria is not yet detected. An increase in the amount of albumin is called microalbuminuria.

Protein in the analysis of urine in a pregnant woman should be absent. Often, protein begins to appear after, when the risk of gestosis increases.

Normally, the result should be negative, but a trace amount of 0.033 g / l is allowed. This value is equivalent to a protein loss per day equal to 150 mg. If the kidneys excrete more protein, then the test becomes positive, which requires further diagnosis. This condition is called proteinuria. It is observed during pregnancy in the following situations:

gestational diabetes mellitus;
urinary tract infections;
nephrotic syndrome;
preeclampsia.

Sugar

Sugar or glucose in urine during pregnancy should be completely absent, since the mechanism of reabsorption in the kidneys implies the constant presence of this carbohydrate in the blood, which should not enter the urine.

Glucose should normally be absent during pregnancy. If the tests indicate its presence, the woman is prescribed repeated studies, as well as a blood test for glycated hemoglobin, insulin levels, a glucose-tolerance test is performed, which excludes or confirms gestational diabetes mellitus.

The sugar level is graded as follows:

negative;
6-15 mmol / l;
16-30 mmol / l;
31-100 mmol / l;
101 mmol / L and above.

The higher the value, the more pronounced the insufficiency of the insular apparatus of the pancreas.

Acetone

Ketone bodies are mainly represented by acetone. This indicator in urine during pregnancy reflects the exchange of fatty acids in a woman's body. This parameter is important in the diagnosis of such a common condition as diabetes mellitus. Therefore, ketone levels are closely monitored throughout gestation. With insufficient fluid intake, during the first trimester toxicosis, acetone is detected quite often.

Acetone and other ketone bodies should be absent during pregnancy. If two, three or four pluses are noted in the test results, additional diagnostics are carried out. One plus may mean insufficient fluid intake on the eve of the test. Often, in the first weeks of pregnancy, ketone bodies are found in the urine, which is due to toxicosis. This condition is corrected by replenishing the prescribed volume of fluid, intravenous infusion of saline solutions. A persistent rise in acetone, which is called ketonuria, may indicate gestational diabetes mellitus.

Erythrocytes in the general analysis

Red blood cells and hemoglobin are not normally present in the urine of a pregnant woman.

The presence of erythrocytes in urine is considered positive if they are detected in an amount of 3 pieces in the field of view during microscopic assessment of the sediment. For the statement of hematuria, it is necessary to pass three urine tests with an interval of 2-3 days. If red blood cells are found in 2 tests, the result is considered positive.

The reason for the appearance of blood in the urine during pregnancy can be:

destruction of red blood cells in the vascular network (toxic effects, immunological conflicts);
destruction of myoglobin with muscle injuries;
convulsions;
glomerulonephritis;
damage to the tissues of the urinary tract (stones, infections).

As a rule, in the presence of stones or infectious and inflammatory processes in the urinary system, gross hematuria is noted, when the urine becomes red or brown, visible to the naked eye. If the urine is red, then the source of bleeding is in the lower urinary tract, if there is a brown tint - in the upper urine (kidneys), such urine looks like meat slops.

Erythrocytes in the analysis according to Nechiporenko

The norm is the content of red blood cells in 1 ml of no more than 1000.

With an increase in this value in three consecutive analyzes, it confirms the pathology of the urinary tract.

Urobilinogen

By analyzing urine, it is possible to determine the state of liver function. The assessment is based on the presence of bile pigments, namely bilirubin and its derivatives (urobilinogen). The result for bilirubin can be positive or negative. Normally, it is negative.

In the analysis of urine, the presence of derivatives of the bile pigment bilirubin, namely urobilinogen, is determined. The parameter is very sensitive in detecting liver pathology. The presence of urobilinogen in urine during pregnancy indicates:

intestinal pathology;
diseases of the liver and gallbladder;
destruction of red blood cells in the bloodstream.

The presence of bile pigments in the analysis is called urobilinogenuria. Such a verdict is made at a value of 17 μmol / L.

Leukocytes in general analysis

The number of leukocytes in urine during pregnancy is one of the most important indicators required for continuous monitoring. Infectious processes, in particular, pyelonephritis, cystitis, colpitis are accompanied by leukocyturia and the appearance of bacteria, mucus.

The number of leukocytes in 1 μl of morning urine should not exceed 4 pieces. As a rule, 4-6 elements in the field of view of pregnant women are considered normal values.

If there is a fact of the presence of an increase in the level of leukocytes in the analysis during pregnancy, they speak of pyuria. It is caused by infections of the genitourinary organs, requiring further diagnosis. An increase in the number of leukocytes in the analysis requires not only a re-examination of urine, but also a smear from the vagina and cervical canal. In the presence of an infection in the urine, not only an increase in the level of leukocytes is detected, but also bacteria, mucus. Leukocytes may slightly increase when the ureters are compressed by the growing uterus.

Leukocytes in the analysis according to Nechiporenko

The norm is the content of white blood cells in 1 ml not more than 2000. With a persistent increase in leukocytes during pregnancy, an infectious lesion of the urinary tract is confirmed. Most often, pyelonephritis is diagnosed during pregnancy.

Epithelium

The epithelium can be represented in the analysis by the following varieties:

flat;
transition;
cells of the renal tubules.

Flat cellular elements are normally present in an amount of up to 5 per field of view. These cells are an integral part of the mucous membrane of the external genital organs and the urethra and constitute the normal urine sediment. Their increase as a result of analysis during pregnancy indicates an inflammatory process (vaginitis, vulvitis, urethritis). Also, flat cellular elements can be increased if the hygiene of the genitals was insufficient.

The transitional epithelium, which was found in the urine, indicates a pathological process taking place in the bladder, ureters. Normally, it should not be.

Renal epithelium is indicative of kidney disease, normally not found.

Nitrite

An indicator such as nitrite can be present in urine during pregnancy in case of infections, since bacteria produce this substance, as well as when eating a large amount of vegetables containing nitrates. You should be aware that during pregnancy, an increased content of nitrates in food can have an extremely negative effect on the health of the fetus. Nitrates combine with hemoglobin and form methemoglobin, which is toxic to the baby.

Well water also contains a lot of nitrates, so during pregnancy its consumption should be excluded.

If nitrites are detected in urine analysis when planning pregnancy, certain tactics are followed.

When re-examining the sample, it is imperative to analyze the morning portion so that the bacteria in the bladder have time to reduce nitrates to nitrites overnight and can be identified.
Discontinue antibiotic therapy three days before retesting.
Eat a sufficient amount of vegetables the day before.

Re-examination during pregnancy takes into account only the first point, since the abolition of the antibiotic or the consumption of vegetables suspected of exceeding the norm for nitrates can negatively affect the developing child.

Cylinders

Cylinders of various types should not be found in urine.

The cylinders are a kind of imprints of the lumen of the tubules in the substance of the kidneys. If pathological processes occur in the filtration system of the kidneys, then various elements formed and secreted by the kidneys (proteins, erythrocytes, leukocytes, epithelium, salts) stick together in the lumen of the tubules and appear in the urine.

Composition and type of cylinders allow you to assess the type of pathological process occurring in the kidneys.

There are several types of cylinders found in the urine with kidney disease.

Hyaline. Formed from a special protein called the Tamm-Horsfall protein, they are found in the analysis for glomerulonephritis, pyelonephritis, heart failure.
Red blood cells. Such casts are represented by red blood cells and are found in glometrulonephritis.
Epithelial. With such a pathological process as tubular necrosis, the renal epithelium begins to form cylinders and is found in the urine.
Grainy. It is this type of cylinder that is most often found during pregnancy. They are formed by leukocytes, bacteria, urates, protein, renal epithelium. Registered with pyelonephritis, obstruction of the outflow of urine when the ureters are compressed by the growing uterus.
Waxy. They are a mixture of granular and hyaline cylindrical elements.
Lipid. Registered with nephrotic syndrome, they are casts from the epithelium and fatty substances.
Rough. They occur with severe urinary retention in the renal pelvis. They are not casts of tubules, but of collecting tubules.
Pseudocylinders. They are inherently fibrin, mucus and impurities, but can be mistaken for any kind of tubular casts.

Cylinders in the analysis according to Nechiporenko

If in the general analysis of urine the content of the cylinders is not allowed, then the study according to Nechiporenko allows other standards.

So, the number of hyaline cylinders should not exceed 20 per 1 ml, other types should be absent.

Salt

The kidneys filter various minerals into the urine, while the composition of urine is always constant, but with errors in nutrition, metabolic disorders, changes in the acidity of urine, with various diseases, mineral compounds in the form of salts in the sediment may appear in the analysis during pregnancy.

As a result of the analysis there may be a small amount of salts, which is expressed by one plus, 2-4 plus should be the reason for re-taking the test.

Salts, namely their crystals, are dangerous due to the formation of sand and stones, therefore, their identification during pregnancy requires more thorough diagnosis and treatment.

There are several types of crystals.

Urata. They are registered with toxicosis, dehydration, urine reaction below 4 units, gout, renal failure, uric acid diathesis, nephritis, excessive consumption of meat, fish, legumes, chocolate, strong tea, mushrooms.
Oxalates. Appears when eating spinach, sorrel, tomatoes, asparagus, citrus fruits, currants, beets. With their constant detection, the presence of pyelonephritis, gestational diabetes mellitus during pregnancy is not excluded.
Crystals of hippuric acid. They can appear in urine with diabetes, intestinal dysbiosis, impaired renal function, as well as when eating blueberries, lingonberries.
Phosphates. The main reason for the excretion of phosphate in the urine is the consumption of foods rich in calcium and vitamin D (milk, eggs, liver, fatty fish, caviar).

Bacteria and fungi

Various microorganisms, including bacteria and fungi, are often found in urine during pregnancy. Given the decrease in immune activity during pregnancy, infectious agents are able to multiply.

During pregnancy, most often in the analysis of urine, fungi of the genus Candida and various bacteria are found. In order to find out which microorganisms are in the urine, you should donate urine for bacterial culture to determine the sensitivity to antibiotics. Most often, staphylococci, Escherichia coli, streptococci, enterococci, Pseudomonas aeruginosa are found.

Bacteria are the cause of pyelonephritis, urethritis and cystitis, vulvovaginitis. But they are often found with insufficient hygiene of the genitals before passing urine, its prolonged standing.

Diastasis

An increase in the activity of the enzyme amylase in diseases of the pancreas is detected in the urine in the form of an increase in diastase (more than 17 U / h). During pregnancy, such an indicator can be recorded as a consequence of severe toxicosis, which requires hospitalization and treatment. Pancreatitis is a rather serious pathology that requires immediate medical attention.

After receiving several negative results, an ultrasound examination, a general and biochemical blood test and other methods are performed for a woman to confirm the diagnosis and begin treatment.