Prevalence Of Proteinuria And Glycosuria Among Pregnant Women Attending Ante-Natal Clinic

ABSTRACT

The research was carried out at Cottage Hospital UruaInyang, Ika Local Government Area on pregnant women to check the prevalence of proteinuria and glycosuria among the pregnant women. Urine sample was collected from one hundred (100) pregnant women within the month of September and December, 2019 and analyzed usingcombi 2 test strips, where the percentage prevalence of proteinuria was 40% and that of glycosuria 55 indicating a low incidence of proteinuria and glycosuria among the pregnant women. Protenuria and glycosuria can be detrimental to both the health of the expectant mother and the fetus. Therefore pregnant women should always be screened for proteinuria and glycosuria on visit to the hospital in order to avert their complications in pregnancy and possible measures to be taken

Chapter One

Introduction

Proteinuria is the presence of excess protein in the urine. In healthy person, urine contains very little protein an excess in suggestive of illness. Excess protein in the urine often cause the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine (bilirubinuria), retrograde ejaculation, preumaturia (air bubbles in the urine) due to a fistula or drugs such as pyridium. Maternal, proteinuria has been strongly associated with pre-eclampsia, preterm labour, small- for –gestational age babies and perinatal death.

In non- pregnant individuals without kidney disease urinary protein excretion is less than 150mg daily. In pregnancy, urinary protein excretion normally increases substantially hence urinary protein excretion is considered abnormal in pregnant women when it exceeds 300mg/24 hours.

In many women, proteinuria appears to increase further at the time of labour and delivery. Although women with uncomplicated twin pregnancies have greater increase in urinaryprotein excretion than women with single on pregnancies (Leidheimer et al; 2014).

Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the blood stream. Glycosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys (such as fanconi syndrome), producing a condition termed renal glycosuria. Glycosuria leads to excessive water loss into the urine with resultant dehydration, a process called osmotic dieresis.

The renal threshold for glucose ranges from 160mg to 190mg/dl; glycosuria does not occur until the blood glucose rises above this level. The most common causes of glycosuria is diabetes mellitus (DM) but may occur after heavy meal, during emotional stress, and during pregnancy. Glycosuria may also occur in individuals receiving total parental nutrition (TTN) when the rate of infusion of glucose exceeds the ability of the pancreas to produce insulin (WHO, 2014).

Background of the Study

Writing on the prevalence of proteinuria and glycosuria among pregnant women at Cottage Hospital Ika is necessary as proteinuria and glycosuria in pregnancy can be detrimental to both the health of the expectant mother and the foetus and also Ika Local Government Area is a rural area and is possible that the women there are ignorant of these conditions.

Again, there can be an association between high blood pressure and high level of protein in urine especially in late pregnancy (20^th week) and this condition is called preeclampsia (a condition where blood pressure increase abnormally during pregnancy) and this can impair the normal supply of blood to the placenta which inturn can reduce the supply of oxygen and nutrient to the fetus. But, if detected and treated early, women with preeclampsia can sometimes have a normal delivery (Leidheimer and Kanter 2014).

Moreso, pregnant women are at risk of having glycosuria because during pregnancy, the renal threshold for glucose excretion is lowered. The increase in glomerular filtration rate delivers an over whelming glucose to the renal tubules and reabsorption which is normally complete is thus compromised.

Aims and Objectives

The aims and objectives of this study is to;

• Determine the percentage prevalence of proteinuria and glycosuria among pregnant women in cottage hospital Ika.
• Know the possible causes of proteinuria and glycosuria during pregnancy.
• Access the complications of proteinuria and glycosurai to the mother and the baby during pregnancy.
• Justify the important of early diagnosis and taking of possible measures as a way of preventing a high percentage prevalence of proteinuria and glycosuria among pregnant women and possibly preventing the dangers associated with it.