Jane Johnson Preeclampsia Case Summary

Why is glucose found in the urine of people diagnosed with diabetes but not in healthy individuals?

Jane is a 45yo, G2 P1001, who was seen for an ultrasound evaluation and consultation. She does have AMA but conceived during embryo transfer with a donor egg that is age 32. The father of the baby is 62. She does smoke vapor nicotine cigarettes. She has not smoked regular cigarettes for the past couple of years. She also does have asthma but is currently asymptomatic. She reportedly has had some seizures in the past but her last one occurred in 2007, about 9-10 years ago and she has not been treated for over 7 years and at this point in time is doing well and therefore medication would not be indicated at this point in time. She does have one previous delivery in 2013 that was by cesarean delivery. Lastly, she does have some issues with chronic back pain following a car accident and injuries in the past. Currently, however, she is only on acetaminophen by report. Overall, on today’s assessment she has no complaints other than she states that she has had some headaches off/on for the past couple of weeks.

Mrs. Smith is a 28 year old, African American. She stands 5 feet and 6 inches tall, weighing 180 pounds. She is a single mom who is in her twenty eighth week of pregnancy. She has mentioned to her doctor that she was experiencing polydipsia, polyuria, and headaches. At her most recent visit with her obstetrician, she was diagnosed with gestational diabetes. A glucose tolerance test was used to diagnosis Mrs. Smith. This test consist of measuring how well glucose is absorbed by the body. A fasting glucose measurement is taken. Mrs. Smith then drank a solution that contained 50 grams of sugar. One hour later, her blood sugar level was re-measured. Her results came back positive. A second three hour test was ordered that contained 100 grams of a sugar solution. Her blood glucose levels were checked at fasting, one hour, two hours, and again at three hours. By administering these tests, it was determined that she had gestational diabetes based upon her consistently high blood sugar level readings. She has already gained twenty pounds in her pregnancy and admits to splurging on desserts such as cake and ice-cream quite frequently. She does however maintain a healthy diet except she is only consuming about 50 grams of protein daily. She is a third grade teacher at an inner city school. Both her parents have type 2

Gestational diabetes is a disease that affects pregnant women it’s a glucose intolerance that is started or diagnosed during pregnancy. Based on recently announced diagnostic criteria for gestational diabetes, according to the American Diabetes Association, it is estimated that gestational diabetes affects 18% of pregnancies. Pregnancy hormones can block insulin therefore causing the glucose levels to increase in a pregnant woman’s blood. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy (American Diabetes Association). Without enough insulin, glucose cannot leave the blood and be changed to

The amount of glucose detected in the urine was 500 mg/d, measuring above the norm of 130-180 mg/d. A high glucose concentration could be associated with calcium oxalate and calcium phosphate. High levels of glucose may occur with diabetes, renal glycosuria, and pregnancy. A follow-up test for diabetes may be given for these reasons. There was a small indication of bilirubin in the urine sample which should normally pass into the liver. Presence of bilirubin cold indicate live damage or diseases such as hepatitis. No ketones were found in the urine we sampled which is normal. The specific gravity of the urine reflects the patient’s hydration status and the sample measured a normal 1.030. In the urine sample there was a trace amount of blood found. This could require additional resting for a sign of kidney damage or infection, kidney or bladder stones or cancer, and blood disorders. Blood also creates a change in the color of urine, perhaps this had something to do with the abnormal coloring of the urine sample. The PH and urobilinogen were both identified as normal by the test. A trace amount leukocytes were identified in the urine. A small amount of leukocytes are normal and expelled in the urine when they are damaged or killed when fighting an infection. A high number of leukocytes may show signs of infection in the urinary system and create cloudy and foul smelling urine. A positive

Purpose: This lab will examine the difference between the different samples of urine that have either too much glucose or a strong acidic (pH) level, to determine the five types of disorders that each sample of urine might have.

Patient C is an 18 year old healthy female. She has great difficulty producing a very small volume of urine, despite the fact that she has not urinated since the morning. It is discovered that she has only had one donut and two cups of coffee all day. The patient’s urine is an orange/ yellow colour and is very dark, however there is no odor exhibited from the urine, it also has a pH of 6.0. The patient’s urine has no glucose, protein, ketones, bilirubin, or nitrite. There is also no evidence of blood cells in the urine. The patient’s urine seems to be completely normal, despite the fact that it is very dark. This patient is most likely dehydrated. She finds it very difficult to produce urine, meaning, and the only liquids she has drunk since

On 9/27/14 a 26 y/o, 38 weeks and 5 days pregnant woman was admitted to Bellevue Women’s Center in Niskayuna, NY, showing signs of severe preeclampsia accompanied with vaginal bleeding. Preeclampsia is a pregnancy specific condition which presents with hypertension, increased urine-protein concentration, and systemic inflammation. Preeclampsia can eventually lead to placental hypoxia and ischemia which can result in hypoxic injury to the tissue of the fetus in utero (1). In addition, preeclampsia is the precursor to maternal eclampsia. Eclampsia is a condition in which maternal seizures occur which are not caused by any underlying condition other than pregnancy. The most effective treatment in prevention of eclampsia caused by preeclampsia

Preeclampsia is a common and multisystem disorder in pregnancy which results in life threatening complications. It is a condition which occurs only to a pregnant woman or after her delivery, in which the blood pressure elevates after the twenty weeks of gestational age along with development of protein in the urine. Inflammatory activity is also increased along with development of insulin resistance. This way pregnancy highlights the tendency of women to the metabolic syndrome of resisting insulin which can appear in life at the later stages.

Preeclampsia is defined by hypertension and proteinuria during pregnancy. It tends to occur after 20 weeks in gestation.

. It is more likely that preeclampsia is predominantly placental or predominantly maternal. Early-onset and late-onset pre-eclampsia have different attributes and are now generally accepted as subtypes of preeclampsia (von Dadelszen, Magee and Roberts, 2003). Although early-onset pre-eclampsia is considered primarily placental, there is also evidence for a much greater risk of later life maternal cardiovascular disease (Staff et al 2013). Hence, early-onset pre-eclampsia includes both placental and maternal components (Staff et al 2013).

Glucose in the urine could be a potential sign for diabetes mellitus because the body produces too much glucose and that contributes the presence of glucose in the urine. Sometimes the intake of food that contains too much carbohydrates, medication, or pregnancy could be also the cause for glucose in the urine. If glucose is detected in the urine farther testing is necessary to find the cause.

Preeclampsia is one of the most common hypertensive disorders that occur during pregnancy. According to Ricci (2013), “Preeclampsia can be described as a multisystem, vasopressive disorder that targets the cardiovascular, hepatic, renal, and central nervous systems.” This disease can be either mild or severe, and it can also progress to eclampsia if not treated properly. According to Arun

According to the American Diabetes Association, the prevalence of gestational diabetes is as high as 9.2% in pregnant women due to obesity or being overweight. Not only can it be harmful to the mother, but it can also be harmful to her baby. Gestational diabetes can increase the chances of pregnant women delivering a baby that weighs more than 9 pounds. Having gestational diabetes can also increase the mother’s chance for needing a cesarean section delivery. Some other risk factors that the mother can be a candidate for developing gestational diabetes by is having a family history of diabetes (especially if a parent or sibling has diabetes) and having gestational diabetes in previous pregnancies. Pregnant women don’t need to have had diabetes before in order to develop gestational diabetes. They can just have high blood glucose levels during pregnancy to get gestational diabetes. There is a process in which the baby has to go through inside their mother’s womb. The placenta is what supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother 's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother 's body to use insulin. She may need up to three times as much insulin. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be

Preeclampsia is the new onset of hypertension and either proteinuria or end-organ dysfunction after 20 weeks of gestation in a previously normotensive woman. Although most women develop signs of the preeclampsia in late pregnancy with gradual worsening until delivery, a few studies have reported delayed or new-onset postpartum preeclampsia in patients with no antecedent diagnosis of hypertensive disease in the current pregnancy (). Postpartum preeclampsia is defined as the presence of hypertension and proteinuria, occurring up to 4-6 weeks after delivery (yancey, filetti). While the pathophysiology of preeclampsia involves abnormal placental vasculature and altered maternal systemic endothelial function (gilbert, beckmann), postpartum preeclampsia