Urine Test During Pregnancy – All You Need To Know About Urinalysis And Urine Culture

Written by K. Masthoff • 
 

Table Of Content:

Motherhood is one of the most beautiful phases in a woman’s life. You will agree with this once you get over the initial morning sickness. Like all expectant mothers, you will want your pregnancy to be smooth. Your OB/GYN will ensure this happens, and of the ways is by performing a urine test.

Usually, your doctor will first perform a urine test to confirm your pregnancy and then as a part of your prenatal care you will have regular tests to make sure you have no health-related issues that could adversely affect you and your growing baby.

Urine Test For Pregnancy:

Your first urine test, in all probability, will be at home when you suspect to be pregnant. The first thing you do after missing your menstrual period would be to purchase a home pregnancy test kit. The kit checks the presence of human chorionic gonadotropin (HCG) hormone in your urine, and depending on sensitivity, it detects pregnancy a few weeks after conception.

It is after getting a positive result at home that you will go to a doctor, who would suggest urine and blood tests to confirm your pregnancy. A pregnancy test done by a certified laboratory is usually accurate and involves testing the blood and urine for the presence of HCG.

The doctor will ask you to collect urine sample midstream. Make sure the sample does not get contaminated with hair and feces. A drop of this sample will be placed on a chemical strip to check for the presence of HCG. Usually, the hormone starts circulating in your body 10 days after conception [1]. The doctor then confirms your pregnancy and your prenatal care begins.

You start your pregnancy period with a urine test and these tests will continue until the third trimester. Tests will help your doctor detect any infections in your body and treat them. Medical science has advanced so significantly that maternal infections, if any, can be treated with antibiotics that are safe during pregnancy.

[ Read: Steps To Do An Accurate Urine Test For Pregnancy ]

Urine Test During Your First Prenatal Care Visit:

A urine test is common during the first prenatal care visit. This allows the doctor to make sure that you don’t suffer from health problems that could pose a risk to your pregnancy. After the initial test, you will continue to have periodic urine tests.

[ Read: The First Prenatal Visit ]

Urine Test During Pregnancy – What Does It Look For?

Urine test during pregnancy allows the doctor to assess the health and functioning of your kidneys and bladder. It lets your OB/GYN detect kidney or bladder infections, preeclampsia, dehydration and diabetes by testing your urine for sugars, proteins, bacteria, and ketones [2]. If their level is high, the doctor will make a certain diagnosis based on it and then prescribe the next course of treatment and healthcare.

What Does Urine Test During Pregnancy Involve?

You can have a urine test any time of the day. In fact, the time of sample collection doesn’t make a difference to the outcome of the test. The only caveat is making sure the sample doesn’t get contaminated during collection. So, before you collect midstream urine sample, wipe your genital from front to back to prevent the sample from getting contaminated by bodily secretions and bacteria. Place the sample cup into your urine stream and collect sufficient amounts of urine, about two ounces.

Usually, the pathologist checks the urine sample right away using chemically treated strips. So you get the results within a few minutes. If the doctor see the need for in-depth analysis, your sample could be sent to a laboratory for further testing. This testing is referred to as urinalysis.

[ Read: Glucose Tolerance Test In Pregnancy ]

Urinalysis In Pregnancy:

The pathologist has several parameters that he will use to test your urine. This testing begins with the visual appearance of your urine and then goes into chemical analysis.

1. Color Of Urine:

Your urine gets its color from its concentration and the presence of chemicals. Usually, it is yellow in color due to naturally present pigment called urobilin, which forms when heme is broken down. Heme is the iron-containing part of hemoglobin and has a role to play in cell differentiation and protein synthesis. [3]

The color of your urine is an indicator of several things:

  • Red urine can mean you have eaten blackberries or beetroots, or you suffer from hematuria, which is presence of blood in the urine. [4]
  • Orange urine indicates presence of bile pigments due to obstruction of the bile duct or taking certain medications, such as phenothiazine.
  • Dark yellow urine is indicative of eating carrots or taking riboflavin (Vitamin B2). It can also mean you are dehydrated.
  • Greenish blue urine is present when you take medications such as amitriptyline or cimetidine. It can also occur if you have taken the sedative propofol.
  • Brown urine represents antimalarial medications. It also can occur due to bile pigments or presence of melanin, which is a sign of metastatic cancer.
  • Cloudy urine occurs due to a purine-rich diet comprising of meats and beans. It can also develop when you have a renal disease. [5]

2. Urine-Specific Gravity:

Urine-specific gravity or USG gives an idea about the concentration of your urine and the number of particles dissolved in it. This allows the doctor to evaluate your state of hydration and the functioning of your kidneys.

High USG means you suffer from glycosuria. This is a condition where the body eliminates glucose even when blood sugar levels are normal [6]. It can also be an indication of diabetes, adrenal insufficiency or impaired renal function.

3. pH Of Urine:

The normal pH of urine ranges from 4.5 to 8. If your urine is alkaline, it is a sign of bacterial infection. Acid urine means you could have metabolic and respiratory acidosis. Usually, eating large amounts of meat can result in acidic urine. However, consumption of diuretics or being a vegetarian can cause high urine pH.

[ Read: Essential Tests To Take During Pregnancy ]

4. Sugar Level In Urine:

Urine of a healthy pregnant woman contains minute quantities of sugar. If the pathologist finds your urine has high sugar levels, it is a sign of gestational diabetes. This diabetes afflicts pregnant women and occurs due to hormones that prevent the body from using insulin, which is a chemical that transforms sugar in the blood to energy.

If your OB/GYN suspects gestational diabetes, he will suggest a blood test. In the one-hour oral glucose test, your blood will be drawn an hour after you consume a sugary drink. Don’t worry about gestational diabetes. Many women develop it during pregnancy. The good news is it can be controlled with the help of diet and daily exercise. If your gestational diabetes is severe, the doctor may put you on insulin.

Women with diabetes go on to deliver healthy babies. However, it is important your diabetes is treated as the condition may result in large babies, complicating vaginal birth. If you leave your condition untreated, you risk your baby developing heart, spine, and kidney defects.

If your urine test comes back positive, it is not necessary you have gestational diabetes. If you have had a sugary drink or large meal before coming for the test, it will show a spike in your sugar levels. The doctor will ask you to come again for a blood test to give a more accurate picture of your blood glucose levels. Most pregnant women have a blood test between 24 and 28 weeks to test for diabetes.

[ Read: Diabetes During Pregnancy ]

5. Protein Level In Urine:

The presence of protein in urine is called proteinuria. It is indicative of urinary tract infection, chronic kidney disease or kidney infection. If the doctor finds protein in your urine after 20 weeks of gestation, it is an early sign of preeclampsia. This is a condition that increases blood pressure. [7] If left untreated, it can be fatal for you and your baby.

Doctors are still unaware of the causes of preeclampsia. Usually, the presence of protein and elevated blood pressure mean preeclampsia. Your healthcare provider will recommend bed rest and monitor your baby closely. Be prepared for a caesarean or induced labor if the doctor feels your baby has developed enough. This is the only cure for preeclampsia. If your blood pressure doesn’t lower with bed rest, the doctor may suggest hospitalization until the baby is born.

On the other hand, if your blood pressure is within the normal range, but there is protein in your urine, the doctor will suggest a urine culture to find out the bacteria causing the infection. This lets your physician to treat you with the right antibiotic. The results from a urine culture are usually available within 48 to 72 hours. Many OB/GYNs put their patients on broad-spectrum antibiotics and ask their patients to provide another urine sample 24 hours after starting the medication.

[ Read: Protein In Urine During Pregnancy ]

6. Ketone Level In Urine:

Usually, the human body breaks down carbs to meet its energy needs. However, if your body metabolizes fat instead of carbohydrates, it creates acidic by-products called ketones. In case, you have diabetes, a presence of high levels of ketones in your urine is a sign of ketoacidosis, which is a serious condition. It can result in diabetic coma.

If your ketone level is high, the doctor will check your food and drinks. Insufficient food and drinks can result in high ketone levels. Once your food and drinking habits are corrected, your ketone levels will go down. However, if you also suffer from severe nausea and vomiting along with high levels of ketones, you will need hospitalization and get the required nutrients intravenously.

7. Presence Of Bacteria In Urine:

If the urinalysis finds presence of bacteria in your blood, it is a definitive sign of urinary tract infection. It requires treatment as untreated infection can spread to your kidneys and pose serious problems for your baby.

When UTIs are treated quickly and correctly, they do not cause complications. Untreated UTI can damage your kidneys and increase the risk of a premature or low birthweight baby. While the doctor will start you on a safe antibiotic, your sample will be sent for a urine culture to determine the kind of bacteria causing the infection.

[ Read: Blood Test During Pregnancy ]

Urine Culture Test During Pregnancy:

Urine culture is the norm when you go for prenatal examination. This is because many women may have a bacterial infection but without symptoms.

A healthy pregnant woman’s urine is sterile and doesn’t contain fungi, bacteria or any other microorganism [8]. However, sometimes, you can get infected when the bacteria enters your urethra. Women are more prone to urinary infections since their urethra is shorter than males and hence, is closer to the anus. This allows transfer of bacteria from the anal region into the urethra and from there to the urinary tract. You also can get a UTI if your partner has one.

A urine culture helps the doctor identify the bacteria and prescribe the right antibiotics.

If the urine culture returns negative, it means no organisms are present in your urine and hence, you don’t require antibiotics.

Why Does The Doctor Recommend Urine Culture?

Your OB/GYN will ask for a urine culture:

  • To find out the bacteria causing UTI.
  • To decide which antibiotic is the best treatment for you during your pregnancy through a test called sensitivity testing.
  • To find out whether the treatment helped the UTI to clear up completely.

You will have to give a urine sample twice for urine culture. Once for finding out the bacteria causing the infection and the second time to make sure the infection has cleared up and poses no risk to you or your baby.

Preparing For A Urine Culture:

You don’t have to do anything to prepare for a urine culture. But it is best to make a list of antibiotics that you are currently taking or have just taken. Inform your doctor about it.

Try not to ease yourself before you give a sample. It may make it difficult for you to provide a sample. This may force you to drink a lot of water, which will dilute the sample and produce a false negative result.

Collect the urine mid-stream, just like you did for the urinalysis. Usually, the first urine of the day is the best for urine culture, as it will contain high levels of the infection-causing bacteria.

[ Read: Alpha-Fetoprotein Test During Pregnancy ]

Collecting Urine Sample:

  • Wash your hands well before you take the urine sample. This prevents cross-contamination.
  • Then clean your vaginal region properly with tissue to remove any contaminant. Use a front-to-back motion to clean the area.
  • Let the urine initially flow into the toilet and then hold the sample cup mid stream to collect.
  • You may hold your folds of the skin apart while urinating to minimize chances of contamination.
  • Replace the lid after filling the plastic container.
  • Wipe the outside of the container well and transfer it to your refrigerator. You can store the urine sample for up to 24 hours before taking it to the lab for analysis.
  • Follow the lab’s instruction on when and how to bring the urine sample for urine culture.

If you are worried about urine culture, speak to your healthcare practitioner and clear your doubts and worries. Understand the risks of a UTI during pregnancy and the treatment. The more you know, the easier it will be to deal with your situation.

[ Read: E-Coli Infection During Pregnancy ]

Results Of A Urine Culture:

Since the laboratory has to grow the organisms present in the urine, it takes about a one to three days to get the results. Some of the microorganisms take longer than three days to grow in a lab setting. Hence, it could also be a week before you get the complete results.

The report will state the following:

Negative: This means no bacterium or fungus grew in the culture. You will not require treatment.

Positive: If bacteria or fungi grow in the urine culture, the result will be positive. Usually, if the bacteria count is 100,000 or more per milliliter, it means you have an infection. However, if the bacteria count is from 100 to 100,000, it could be an infection or contamination of the urine sample. You will be asked to give another urine sample so that the culture can be repeated. If the count is 100 or less, infection is ruled out. Usually, this result is what you should expect if the doctor puts you on antibiotics and asks for a second urine culture.

Your test results can be affected due to several reasons, including:

  • You are currently taking antibiotics.
  • You have just finished a course of antibiotics.
  • You are taking diuretics, which dilute the urine sample. This reduces the number of bacteria present in the sample.
  • You are consuming a lot of Vitamin C.

Points To Remember About Urine Culture:

Here are a few things you should keep in mind about urine culture and its results.

  • A urine culture may not yield accurate results if performed during the early stages of UTI. It is best to do the culture when the infection has had sufficient time to establish itself.
  • Healthcare practitioner will ask for urine culture only if he observes abnormal results from your urinalysis that indicate an infection.
  • Sensitivity testing allows the doctor to determine the best antibiotic to treat the bacterium or fungus causing your infection.
  • Sometimes, urine culture can take time because certain bacteria and fungi take several weeks to grow in the culture medium. However, you can rest assured as the doctor will not wait that long to treat you. You will be put on broad-spectrum antibiotics until your physician gets confirmation on the type of microorganism causing the infection.

[ Read: UTI During Pregnancy ]

In Conclusion:

Urine test during pregnancy is one of the many routine tests you will have during your prenatal visits. Even if you have to get a urine culture, don’t panic. With early diagnosis and prompt treatment, your infection will clear up without causing any harm to your growing baby.

How did your pregnancy proceed? Did your physician perform a urine test during your first prenatal examination? Did you undergo urine culture? Please comment below so that our new expectant mothers can allay their fears through your experiences.

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