Causes of high white blood cell counts during pregnancy

The main function of white blood cells is to protect the body from infection. In a pregnant woman, an increase in their content to certain levels is considered normal due to an increase in the antigenic load on her body.

In cases where the level in the urine exceeds the standard values, they speak of the development of an inflammatory process in the genitourinary organs.

White blood cells protect the body from infection

Causes

An increased level of white blood cells in medical practice is called leukocyturia. It occurs in pregnant women due to the development of pathologies:

• pyelonephritis is an inflammatory process of a bacterial nature when the tubular system of the kidney is affected. It occurs in pregnant women due to the growth of the fetus and compression of the kidneys by the expanding uterus, which allows bacteria to penetrate the organ. Pathology during pregnancy can lead to the development of gestosis, premature birth, miscarriage, and freezing of the fetus inside the uterus. In terms of a woman’s health, pyelonephritis is dangerous due to complications such as nephrosclerosis, hypertension, sepsis and purulent-necrotic kidney damage;
• cystitis is an inflammatory process in the bladder, the causes of which are hypothermia, hormonal imbalances, changes in the vaginal microflora and the entry of infectious agents from the kidneys. It is diagnosed in 10% of pregnant women. With timely treatment of cystitis, consequences for the health of the mother and child can be avoided;
• candidiasis – damage to the membranes of the genital organs. Diagnosed in the last stages of pregnancy against the background of reduced immunity. When carrying a baby, a woman’s body lacks elements and vitamins, which can trigger the development of dysbiosis. It causes the activation of yeast-like fungi Candida, which spread from the intestines to the vagina;
• urethritis - inflammation of the walls of the urethra. The infectious nature of the disease is observed with chlamydia, as well as damage by pathogenic pathogens living in the woman’s body. Conception can cause their activation. Non-infectious urethritis occurs due to pressure on the urethra of the fertilized egg, which causes injury and the development of inflammation. This type of pathology is diagnosed due to allergic factors. Urethritis is dangerous due to complications on the kidneys and bladder;
• vulvovaginitis - damage to the vaginal lining and labia. To confirm the diagnosis, it is recommended to take a vaginal secretion culture test, which will determine whether there is inflammation in the vaginal area.

An increased level of white blood cells can develop for several reasons.
An increased content of white blood cells in the urine can result from ureteral reflux, in which urine backflows from the bladder into the renal pelvis.
This process can occur due to a woman’s insufficient activity in the last trimester, which leads to a disruption of the outflow of urine due to pressure from the uterus on the bladder.

Leukocytes in urine: what do they indicate?

White blood cells act as “protectors” and help rid the body of viruses and bacteria that cause harm.
When infectious agents enter the bloodstream, the immune system recognizes them and begins producing white blood cells in an attempt to defend itself. If it is not possible to “kill” pathogenic bacteria or the immune system does not react in a timely manner and the number of cells increases, inflammation begins and the person becomes ill.

Leukocytes appear in the urine because they are eliminated from the body in this way.

What else is the white blood cell responsible for?

1. For suppressing the activity of allergens entering the body with food or air.
2. For suppressing the activity of infectious agents that have entered the body of a pregnant woman.
3. The cells are produced during oncological diseases and injuries.
4. The level increases during bleeding, if blood loss is profuse.

It is worth analyzing the concept of leukocytosis - an increase in the level of cells in the blood or urine, and it is pathological in nature and is not associated with:

• with physiological processes and changes, pregnancy;
• with food intake and time of day;
• with physical stress on the body;
• with taking medications of various types.

The above circumstances slightly affect the level of leukocytes in the blood, but they are not associated with infectious or inflammatory processes.

How to understand the indicators of what is considered normal and what is a sign of pathological processes?

Symptoms

A pregnant woman can suspect leukocyturia based on changes in urine status:

• dark color;
• turbidity;
• loose sediment of a mucous nature;
• impurities of blood and pus.

This type of urine requires an urgent visit to a gynecologist to identify the nature of the disease that caused the content of leukocytes in it.

If your urine is dark in color, you should seek help from a doctor.

As the pathological process develops, a woman may experience symptoms:

• painful urination and false urge to urinate;
• pain and cramping in the lower abdomen, in the side;
• burning and itching in the vagina;
• increased body temperature;
• nausea and vomiting;
• loss of appetite.

If you do not consult a specialist, a pregnant woman may quickly develop leukocytosis. Changes in the cellular composition of the blood are preceded by intense bleeding. In some cases, a few hours are enough for a dangerous condition to develop.

Inflammation of the bladder or kidneys

Disorders of the urinary system during gestation are often observed. A sign of inflammation in these diseases is not only an increased number of leukocytes in the urine and blood:

• The woman feels a frequent urge to go to the toilet “in a small way”, but after this there remains a feeling of fullness of the bladder.
• Pain in the lumbar region begins to bother you, and the temperature rises.
• Nausea, vomiting and lack of appetite are signs of intoxication from pyelonephritis during pregnancy. But often women attribute such symptoms to toxicosis.

The course of pregnancy depends on the timely detection of pyelonephritis and cystitis. If the disease passes in a sluggish form and is not detected symptomatically, then in urine tests during the exacerbation period there will be changes, including increased white blood cells. Diagnostics helps prevent intoxication during pregnancy and the death of the child.

Diagnostics

To carry out treatment, it is necessary to conduct the following types of studies:

1. General analysis. It is recommended to donate 1 ruble. per month in the first trimester, 1 rub. every 2 weeks – II trimester, every 7 days – III trimester. The norm for a pregnant woman is the presence of 3-6 leukocytes in the field of view. When their level increases to 10-20, the presence of inflammation in the urinary system is assumed, and when 40-50 – in the kidneys.
2. According to Nechiporenko. Prescribed for poor urine test results. It is used to determine the number of leukocytes in 1 ml of urine. The standard value is 2000 in 1 ml. It is necessary to collect an average portion of morning urine for analysis.
3. According to Zimnitsky. It makes it possible to assess the functioning of the kidneys and involves collecting analysis every 3 hours in a separate container (8 jars). The total volume and amount of material at specific hours are taken into account. When conducting a study, the doctor asks the woman to record the amount of water she drinks during the day, and intravenous solutions are also counted. Normally, the kidneys should process 75% of the fluid drunk by a woman, and daily diuresis should not be less than 2/3 of the total volume of urine.
4. Urine culture tank. It is carried out to identify the infectious pathogen and determine its sensitivity to the antibiotic.

In order for the analysis to show results, you must follow the rules:

• per day, a woman’s diet should not be oversaturated with protein products (meat, cottage cheese, milk cheese), fruits, berries with a high content of vitamin C. When treated with medications (diuretics, antibiotics), with the permission of the doctor, you should stop taking them;
• buy a plastic cup at the pharmacy or thoroughly treat a glass jar with boiling water;
• before collecting urine, you need to toilet the external genitalia;
• For analysis, it is necessary to collect morning urine, direct the first stream into the toilet, and then, without interrupting the process of urination, place the container. Pregnant women are advised to insert a tampon into the vagina to prevent blood from entering;
• The glass is immediately closed tightly with a lid and delivered to the laboratory within 1.5-2 hours.

Other indicators and their normal values

In addition to leukocytes, the study of urine evaluates it according to such criteria as color, transparency, specific gravity, pH, the presence of salts, protein, bilirubin, glucose, ketone bodies, epithelium, red blood cells, and casts is determined. Normally, a single presence of leukocytes and erythrocytes in the urine during pregnancy, as well as salts, casts and epithelial cells, is allowed. There should be no other inclusions. The medium should be transparent, yellow, acidity 5.0 - 7.0.

Treatment

The doctor selects treatment methods and medications depending on the nature of the disease, the type and number of pathogens, as well as the duration of pregnancy and the general condition of the woman.

For mild inflammation, a specialist may prescribe decoctions based on the following herbs that have a disinfectant and diuretic effect:

• black currant;
• chamomile;
• cowberry;
• cranberry.

The disease can be treated using folk remedies.
A diuretic drug of plant origin is used - Canephron. The dosage is 2 tablets 3 r. per day. These types of medications help eliminate the infection by removing urine. They should not be used for hypersensitivity, as well as for women with a predisposition to allergies. The course of treatment is determined by a specialist.

In the case of a pronounced inflammatory process or ineffective therapy, the following drugs are prescribed:

• Clotrimazole. Pregnant women use an antifungal agent in the form of suppositories. Therapy includes inserting 1 suppository into the vagina before bed for 10 days. Clotrimazole is not used in the first trimester of pregnancy and in case of individual intolerance;
• Monural is a broad-spectrum antibacterial agent. It is dissolved in 70 ml of liquid and drunk 1 r. per day 2 hours before meals (before dinner). Contraindicated in renal failure;
• Amoxicillin is a bactericidal antibiotic. The dosage usually used is 0.5 g. 3 r. in a day.

The drugs should be used with great caution and strictly as prescribed by a doctor, as they have many side effects. Pregnant women refuse to use antibiotics for fear of harming their unborn child.

Prevention

To protect yourself from possible infections of the urinary and genital organs during pregnancy, you need to follow the following rules:

• take all clinical tests prescribed by your doctor;
• if symptoms of infection appear, begin treatment;
• avoid hypothermia, stress or physical activity;
• Do not neglect walks in the air.

It is important for a woman to stay healthy during pregnancy. Any complications can negatively affect the child and sometimes lead to death. Leukocyturia is dangerous due to complications; in no case should you refuse treatment.

What to do if a pregnant woman has leukocyturia

In order not to miss and treat in a timely manner a newly emerging or aggravated old MPS disease, pregnant women should regularly undergo OAM:

• in the 1st trimester - once a month;
• in the second trimester - once every half month;
• in the third trimester - weekly.

If leukocytes in the urine are elevated during pregnancy, the doctor asks the woman to retake the test, again explaining in great detail how to collect it correctly.

If leukocyturia is detected in the repeated analysis, additional tests are prescribed (a study according to Nechiporenko, according to Zimnitsky, an ultrasound of the kidneys is done, a consultation is carried out with a urologist, gynecologist, and, if necessary, a rheumatologist, phthisiatrician).

The first thing a pregnant woman needs to do is to follow all the doctor’s orders without panic.