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Laboratory test Preeclampsia usually shows up during a routine prenatal blood pressure check followed by a urine test.

The diagnosis depends on the presence of high blood pressure and protein in your urine after 20 weeks of pregnancy. Substances called biochemical markers in your blood and urine may be warning signs of preeclampsia. That's one of the reasons it's essential to seek early and regular prenatal care throughout your pregnancy. The following laboratory tests were recommended:

Blood tests. These can determine how well your liver and kidneys are functioning and whether your blood has a normal number of platelets the cells that help blood clot. Prolonged urine collection test. Urine samples taken over at least 12 hours and up to 24 hours can quantify how much protein is being lost in the urine, an indication of the severity of preeclampsia. 24 Hour Urine for Protein and Creatinine Creatinine is a product of muscle metabolism. It is produced at a nearly constant rate and is excreted in the urine.

Because of it's constant rate of production, the amount of creatinine in the urine is an indirect measurement of kidney function (glomerular filtration rate). If kidney function is significantly reduced, the urine creatinine will fall. With more severe degrees of kidney failure, the serum creatinine will eventually rise. A 24-hour collection of urine is the most accurate way to assess renal function with creatinine. A blood (serum) creatinine is also measured during this time and used to calculated the volume of urine needed to "clear" the measured amount of creatinine from the blood and into the urine. This is called the "creatinine clearance." Vigorous exercise or muscular trauma occurring during the collection will cause an increased amount of creatinine in the blood and may lead to false creatinine clearance results. Serum proteins are normally extracted from urine prior to it being released from the kidney.

Because the renal glomeruli are imperfect, normal individuals may occasionally have "trace" amounts of protein in their urine. Larger amounts (1+ or more) are considered abnormal and may reflect an underlying kidney problem. Urine protein can be measured on any urine sample (a "spot urine"), but the most accurate measure is with a 24-hour collection of urine.

During pregnancy, due to the increased renal blood flow, some additional protein may be lost in the urine. This increased protein loss should not normally be in quantities exceeding 300 mg in 24 hours. If more than 300 mg in 24 hours is found, this may signal the development of pre-eclampsia.

Fetal ultrasound. Your doctor may also recommend close monitoring of your baby's growth, typically through ultrasound. This test directs high-frequency sound waves at the tissues in your abdominal area. These sound waves bounce off the curves and variations in your body, including your baby. The sound waves are translated into a pattern of light and dark areas creating images of your baby on a monitor that can be recorded electronically or on film for a look at the inside of your uterus. Nonstress test or biophysical profile. These make sure your baby is getting enough oxygen and nourishment. A nonstress test is a simple procedure that checks how your baby's heart rate reacts when your baby moves. Your baby is doing fine if the heart rate increases at least 15 beats a minute for at least 15 seconds twice in a 20-minute period. A biophysical profile combines an ultrasound with a nonstress test to provide more information about your baby's breathing, tone, movement and the volume of amniotic fluid in your uterus.

Reference: http://www.brooksidepress.org/Products/OBGYN_101/MyDocuments4/Lab/24hour_Urine_for_Protein_and_Creatinine.htm http://www.mayoclinic.com/health/preeclampsia/DS00583/DSECTION=tests-and-diagnosis

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