North American Registry of Midwives (NARM) Practice Exam

Is it common for proteinuria 2 + and above to be present in labor?

1. Yes, always normal

2. No, it’s indicative of preeclampsia

3. Only in primiparas

4. Only during prolonged labor

The correct answer is: No, it’s indicative of preeclampsia

Proteinuria of 2+ and above during labor is most recognized as an indicator of preeclampsia. Preeclampsia is a serious condition characterized by hypertension and signs of end-organ dysfunction, which can include elevated levels of protein in the urine. Typically, proteinuria that reaches this level is not considered a normal finding; instead, it suggests potential complications that need to be assessed and managed properly. In the context of labor, the presence of significant proteinuria must be evaluated alongside other clinical signs and symptoms, such as elevated blood pressure and the presence of other systemic issues. This is essential for ensuring the safety of both the mother and the baby. While there can be instances of transient proteinuria with no pathological implications, the specific context of 2+ and above in labor raises concerns that deserve clinical attention. Other options do not accurately convey the clinical significance attached to elevated protein levels during the labor process. Understanding the relationship between proteinuria and preeclampsia is crucial for effectively managing labor and anticipating outcomes for both mother and child.