Urinalysis for the ob-gyn: Advanced interpretation, when to refer, and underappreciated parameters

UA is one of the most commonly ordered diagnostic tests in obstetrics and gynecology.¹ It plays key roles in routine prenatal care, in infection monitoring, and in evaluating genitourinary complaints, such as dysuria, gross hematuria, or suprapubic pain.² Not only is it low cost, but it also has a rapid turnaround time, which allows for the test results to directly influence decisions around screening, diagnosis, and referral in the acute care setting.³ However, beyond its use in identifying UTIs or monitoring proteinuria during pregnancy, urinalysis offers a wealth of additional information that is often overlooked. Specific findings may indicate systemic disease, renal pathology, or complications warranting further evaluation.¹ This review aims to go beyond the basics by exploring advanced interpretations, including lesser‑focused parameters, pitfalls, and indications for clinical referral to support ob-gyn providers in translating UA findings into practical care decisions.