Why Your Urine Is Tested at Every ANC Visit
What does urine testing detect during pregnancy and what do abnormal results mean?
18/08/2026
What a Urine Test Checks For
A urine test (urinalysis) at each ANC visit checks for three main findings: protein, glucose, and signs of infection (bacteria, white blood cells, nitrites). Each of these findings indicates a different potential problem and triggers a different response from your health provider.
Testing is done using a simple dipstick that is dipped into your urine sample and read within minutes. Despite its simplicity, this test is one of the most important screening tools in pregnancy care, detecting conditions that could otherwise progress to serious complications.
Protein in Urine — Warning Sign of Preeclampsia
Protein in the urine (proteinuria) — particularly when combined with high blood pressure after 20 weeks of pregnancy — is the defining feature of preeclampsia. Normally, the kidneys filter protein back into the bloodstream and very little passes into the urine. When the kidneys are damaged by preeclampsia, protein leaks through.
A trace of protein in the urine can be normal. Significant or increasing levels of protein, especially alongside elevated blood pressure, require urgent assessment and often hospital admission. Your provider will trace the result over multiple visits — an upward trend is as important as any single reading.
Glucose in Urine — Screening for Gestational Diabetes
Finding glucose in the urine can indicate gestational diabetes mellitus (GDM) — a form of diabetes that develops during pregnancy and affects approximately 5–10% of pregnancies globally. GDM is associated with very large babies (macrosomia), which increases the risk of difficult or complicated delivery. Babies born to mothers with uncontrolled GDM are also at higher risk of neonatal hypoglycaemia (low blood sugar at birth) and breathing difficulties.
Detecting glucose in the urine triggers a referral for a confirmatory blood glucose test. If gestational diabetes is confirmed, management includes dietary modification, blood glucose monitoring, and sometimes insulin therapy. GDM usually resolves after delivery, but is a risk factor for developing type 2 diabetes later in life.
Signs of Infection — Urinary Tract Infections
Urinary tract infections (UTIs) are significantly more common during pregnancy due to hormonal changes that affect the urinary system. A UTI in pregnancy carries higher risks than outside pregnancy — an untreated bladder infection (cystitis) can ascend to the kidneys (pyelonephritis), causing severe infection, high fever, and preterm labour.
A urine dipstick showing white blood cells, nitrites, or bacteria triggers a referral for a urine culture to identify the specific bacteria causing the infection. Treatment with a pregnancy-safe antibiotic is started promptly. Completing the full course of antibiotics even if symptoms resolve is essential to prevent recurrence.
How to Collect a Urine Sample
To ensure an accurate urine test at your ANC visit, collect a clean-catch midstream sample. Begin urinating into the toilet, then — midway through — place your sample container in the stream to collect the urine. This reduces contamination of the sample by bacteria from the skin or genital area, which can give a false positive result for infection.
Collect the sample as close to your appointment time as possible, ideally at the health facility immediately before your appointment. Tell your provider if you have recently taken antibiotics, as this can affect the test result. Your provider will give you a container at your first visit.
Related Articles
ANC: More Than Just a Clinic Visit
Antenatal care is a comprehensive programme of health checks, tests, treatments, and education — not just a routine appointment. Here is what ANC actually delivers for you and your baby.
Read articles
When Should I Start ANC?
Rwanda MoH and WHO both recommend starting ANC before 12 weeks. Here is why early registration is critical and what to do if your pregnancy was discovered late.
Read articles
How Many ANC Contacts Should I Have?
Rwanda MoH recommends a minimum of four ANC contacts, while WHO recommends eight or more. Here's the schedule, what each contact delivers, and why none should be missed.
Read articles