February 3, 2000
Complications, Family Planning
Question from South Carolina, USA:
I am a 31 year old female with a 26 year history of IDDM, now on a pump. I am currently pregnant with my third child. My other two pregnancies were uneventful, with healthy outcomes for mom and babies. On a 24 hour urine during my first trimester, my microalbumin was elevated (155 with a normal of <20). Is this "normally abnormal" for pregnancy? Microalbumin just prior to conception was 4mg per 24 hours; no other complications ever.
Answer:
The degree of microalbuminuria suggests that you have mild diabetic nephropathy. You should not have any protein in your urine during pregnancy.
Obstetricians usually do not get worried until there is more than 300 mg/day. However, in the face of diabetes even a small amount of protein could be significant. As long as your blood pressure is normal there is no additional treatment at this time. But it will be worthwhile to repeat the urine collection every trimester.
OWJ
