Urine test

Routine urine testing at every pregnancy visit is becoming less common in Australia, mainly because it has been found to have little benefit for either the woman or her baby, unless other physical signs are present (such as higher blood pressure). However, some obstetrician continue to routinely test every woman’s urine at every pregnancy visit.

The following is why your urine may be tested

• Pregnancy test
• Urine infection
• Protein
• Glucose
• Ketones

Pregnancy tests

Modern urine pregnancy tests detect the presence of human gonadotrophin hormone or HCG; they can be up to 97% accurate.

Urine infection

About 5 – 10 % of women (pregnant and non-pregnant) have what is called “asymptomatic bacteruria”, a small amount of bacteria present in the bladder without the women actually having any physical signs. About 30 % of pregnant women with asymptomatic bacteruria can develop a urine tract infection later in their pregnancy, possibly leading to premature labour and birth in 50% of cases if left untreated.

The physical signs of a urine tract infection can include:

• Passing urine more frequently
• A burning sensation when urinating
• A constant ache in the lower belly
• Headache, vomiting, low blood pressure ± a fever or chills

The most common bacterium causing a urine infection

• E. coli, which is present in large quantities in the bowel and the vagina
• Group B streptococci, known as GBS

To test for urine infection, you need to provide a mid-stream sample of urine passed into a sterilized container (also called a MSU). Taking a sample midstream involves you passing a little bit of urine into the toilet, then passing a small amount of urine into the sterile container (this is the middle of the stream), then passing the rest of your urine into the toilet.

Protein

Protein in the urine is tested for by using rapid urine screening tests, known as dipsticks. The results of a dipstick test show as negative, or ‘a trace’ or 1+, 2+, 3+ or 4+.

During pregnancy, it is normal for the kidneys to excrete small amounts of protein (trace to 1+). However, large amounts of protein in the urine (or proteinuria) can be a physical sign of

• Very high blood pressure (pre-eclampsia)
• Urine tract infection
• Underlying kidney disease

The definitive test for proteinuria is a 24-hour urine collection, which means you collect all your urine over a 24 hour period in a large plastic container. Proteinuria is not considered abnormal until it exceeds 300mg in 24 hours.

Glucose

Glucose in the urine is a very normal physical variation during pregnancy. Glucose in the urine in pregnancy is not an indicator for diabetes. Diabetes can only be tested for with a glucose tolerance test.

Ketones

Ketones may be passed into the urine if a person is dehydrated and lacks sufficient carbohydrates (or glucose) in their blood stream for energy in the body. If the muscles have little or no glucose for energy to function efficiently, they start breaking down the body’s fat stores for energy instead, producing ketones that can be detected in urine.

Currently, they are now only tested for during pre-labour or labour to monitor hydration and energy reserves.

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