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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31316
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hi, my wife had a mild pre-eclempsia (with BP 135/90, 0,3-0,7

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Hi, my wife had a mild pre-eclempsia (with BP 135/90, 0,3-0,7 g/L of protein in urine and some edema), she was hospitalized a week ago at 35 weeks of pregnancy. Her BP is almost the same after a week in hospital, with spikes up to 145/98, but protein has been rising. Last days it was 1, 2, 1, 3, 2 and this morning it is 6 g/L (all in morning urine sample, NOT a 24h urine). This is weekend now and hospital care is not as good as during regular days and I am very concerned there will be permanent issues with kidneys. Doctors planned to induce labor next week, perhaps Wednesday, waiting for pregnancy to be almost 37. Should I be concerned and seek for additional options?

Can you please tell about the other blood investigations and ultrasound report?

Thank you.

Dr. Arun
Customer: replied 3 years ago.
Baby is so far ok in general, FHR being in range of ~130-150, movevement are also fine (at least it was until yesterday). Last ultrasound examination was done couple of days ago and all was ok, including doplerography of umbilical cord blood flow. The other blood concern for last week was low blood protein (56 g/L with indicated norm of 66-83 g/L), but that was 6 days ago (13th of May) and not repeated. On the same day they also checked creatinine and urea which both were fine. Also, they checked liver enzymes (AST, ALT) which were also ok. After that they are only doing full blood count and morning urine protein, so I am really thinking to insist on additional blood work to check kidney and liver function. Oh, and her diuresis seems to be quite constant and fine - 2,2 - 2,5 L/24h. One more thing - they thing baby might be behind 1,5-2 weeks according to size, but one doctor also says it is possible that it is because of genetic predisposition of us, my wife's weight before pregnancy being 50 kg, 162 cm and I am 69 kg, 182 cm.
Hello Robert,

With creatinine (which is a good indicator of kidney functions with routine urine) and AST, ALT (good indicator of liver functions) being normal and blood pressure not rising; damage to kidneys is not likely. The proteinuria would cease after the induction of the labor and delivery. So please do not worry. Prognosis is good here.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 3 years ago.
I am worried they have checked creatinine and AST, ALT almost a week ago and are not monitoring dynamics. Is it possible these could change during few days?
Customer: replied 3 years ago.
6 g/L of protein in urine seems a bit extreme, and the rate of change from 2 g/L yesterday is also worrying. Isn't this alone a reason for concern and reason to induce labor tomorrow instead of waiting any longer?
Customer: replied 3 years ago.
Ok, perhaps I have the answer, rushing to hospital, they have put my wife on oxytocin.
Hello Robert,Just the rising proteinuria of this magnitude solely is not an indication of inducing the labor usually. But since they have started the induction; some minor factors like mild growth retardation may have been the reason for early induction. Liver and kidney are high reserve organs; so investigations are unlikely to change in just a week. Nothing worrisome here.It is privilege assisting you.Dr. Arun
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Customer: replied 3 years ago.
Hi Dr. Arun,

I was mistaken by saying they have put my wife on oxytocin. As soon as she told me they have connected IV, I thought they are inducing labor. Aparently they have decided it is too risky to induce labor perhaps the fact that her BP started to rise really fast. It was 155/110 when she woke up in the morning, s o the IV was just Ringer infusion/electrolytes, preparing for C-section. I was a bit too late to ask questions like this, I suppose :) We have a son, both -him and my wife in ICUs. Doctors have confirmed the diagnosis of preeclampsia and are waiting for her BP and protein to go down before they release her from ICU. BTW, baby is born 2kg with rating of 8/9 out of 10, so all is well. Thanks for your help!
You are very welcome, Robert. Congratulation on the baby.

I know this was turbulent, but the high blood pressure and proteinuria are likely to improve fast after the C-section.

Good luck.

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