Blood in urine during pregnancy

Blood in urine is medically known as hematuria. Only if there are a lot of red blood cells in the urine, makes the urine look darker, which can be easily noticed (macroscopic hematuria). On the other side, in case there is a small number of red blood cells in the urine, the color of the urine does not change and the problem can be only identified with urinalysis (microscopic hematuria). It is not normal for a pregnant woman to suffer from hematuria (either macroscopic or microscopic). If this occurs, it is essential to find the underlying cause as soon as possible and treat the pregnant woman accordingly.

Blood in Urine during Pregnancy: Causes

One of the most common causes of hematuria during pregnancy is an infection of the urinary tract. Pregnant women are, in general, more susceptible to urinary tract infections. In pregnant women, the enlargement of the uterus may cause compression of the bladder and interfere with its normal emptying. The residual urine is a perfect basis for the growth and multiplication of bacteria and consequent bladder infection.

Furthermore, hematuria during pregnancy may result from kidney and/or bladder stones. As the stone passes down the urinary tract, it leads to damage to the ureter, bladder, and urethra. This damage is always accompanied by red blood cells in the urine. Apart from hematuria, passing kidney or bladder stones always leads to severe pain.

Hematuria during pregnancy may also point to the presence of even more serious disorders of the upper urinary tract (kidneys). It can affect women suffering from lupus, sickle cell anemia, and diabetes. And finally, on very rare occasions, hematuria during pregnancy develops as a consequence of bladder or kidney cancer.

Blood in Urine during Pregnancy: Diagnosis and Treatment

Urinanalysis is a simple test that can confirm the presence of blood in the urine. Once hematuria is identified it is necessary to determine its cause. The doctor performs additional tests and examinations such as urine culture, ultrasound, and several more blood tests. Once the definitive cause is determined the woman may be treated.

Since pregnancy represents a very delicate period there are certain limitations when it comes to treatments. Namely, pregnant women may not be prescribed all medications and should not undergo certain diagnostic or therapeutic procedures. The doctor opts for the most suitable medication for the very condition and pays attention not to prescribe medications that can cause damage to both the mother and the baby. Fortunately, hematuria during pregnancy can be successfully treated and brought under control.

Preterm labor, fetal growth restriction, low birth weight, and preeclampsia are considered as the most important and most common adverse pregnancy outcomes. Hypertensive disorders occur in the course of 5–10% of all pregnancies and can be allocated a major contribution to maternal morbidity and mortality.

Incidence of microscopic hematuria during pregnancy has been reported 3–20%, and subsequently, its association with increased risk of preeclampsia has been reported from 2 to 8 times more than normal.
Because of the preeclampsia is a major cause of maternal mortality, it is important prognostic factors. Urinalysis test is low cost and can be done in the first prenatal care visit, and it can estimate the risk of preeclampsia during pregnancy. Further, it can reduce heavy financial and emotional burden of preterm birth. The aim of this study was investigation of the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy.
Urinalysis was done for 700 pregnant women before 24 weeks of pregnancy. Those who had 3–5 red blood cells per milliliter in urinalysis were considered positive urinalysis. Then, all individuals were examined for blood pressure and other alarm signs of pregnancy complications in each visit. All mothers were followed for the incidence of preeclampsia, preterm delivery, and pregnancy outcome until the end of pregnancy.

✓ Fact confirmed: Investigation of the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy Azar Danesh Shahraki, Mahboobeh Esteki Bardeh, and Mohammad Reza Najarzadegan; 2016 Nov 28.