Swollen Ankles, High Protein in Urine, But Normal BP: How Concerned Should I Be?

My wife is 31 weeks pregnant with normal blood pressure but higher than normal blood protein levels, a symptom of pre-eclampsia. She's been violently nauseated twice in the past week. Could it be the combination of hot weather and working too hard? She's quitting work soon. As I have no way of monitoring her blood pressure, what am I supposed to do?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I can understand your concern. Protein in the urine in amounts greater than plus-one is a sign that further testing should be done. Her provider should have collected a clean catch specimen to see if there is still protein present. If there is, and if there is significant swelling, it could be an early tendency to develop pre-eclampsia. But these symptoms with the nausea can be symptoms of working hard and the hot weather as well.

I recommend that she be seen every week for urine and a blood pressure checks. Your provider could supply you with some dip sticks and she could go almost anywhere to have her BP checked (nurse at work, public health nurse, school nurse, fire department).

Recently, they have been doing some research with calcium and pre-eclampsia, and it may be beneficial for your wife to make sure she is getting 2 gms (2,000 mg) per day (milk, dairy, fortified orange juice). Make sure she is getting enough water and fluids in her diet, too. She should rest on her left side two hours a day and keep her feet elevated whenever possible. If she develops pain in her upper abdomen or any visual disturbances, swelling (edema) in her face or headaches, she should call her clinic right away.

It is good that she is quitting work soon, as this may be all that she needs.

This may be a false alarm, but better to be safe and have her follow these guidelines. It could be just stress and climate and nothing more.

Best of luck with the rest of the pregnancy.

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