Leukocytes during pregnancy: causes of increase, consequences and prognosis

Leukocytes during pregnancy: causes of increase, consequences and prognosis

24.05.2022 0 By admin

Leukocytes during pregnancy is an important laboratory indicator that indicates the state of the immune system. Given the high load on the body during gestation, the laboratory parameters of biological fluids and a smear from the cervical canal are unstable, constantly changing as the gestation period increases. An episodic increase in leukocytes is more often due to physiological factors: a violation of the diet, overweight, stress, overwork, and a cold. With a persistent increase in leukocytes, leukocytosis is suspected against the background of various diseases, pathological conditions.

white blood cells during pregnancy

A change in the number of leukocytes during pregnancy may indicate a decrease in immunity or the addition of pathogenic microflora

Reasons for the increase

With an increase in leukocytes in the composition of biological fluids at any stage of pregnancy, control tests are required after a certain time. The appearance of a small number of leukocytes in the field of view can be caused by such factors:

  • hypothermia;
  • severe fatigue, overexertion;
  • psycho-emotional arousal, stress loads;
  • increased physical activity;
  • inadequate nutrition.

The condition is normalized when the provoking factors are eliminated. For a reliable result, several tests are sufficient, which should correspond to the patient’s clinical history. However, there are also pathological causes of an increase in leukocytes, which require special attention from clinicians:

  • inflammation of the respiratory tract of any nature;
  • parasitic infestations;
  • exacerbation of chronic infectious diseases of any localization, pathogenesis;
  • acute inflammation of the genitourinary system;
  • aggravated allergic history;
  • autoimmune diseases;
  • internal bleeding, iron deficiency anemia;
  • intoxication.

Certain medications, complicated pregnancy, and complications of endometriosis can affect the shift of the leukocyte formula to the left. Leukocytosis is always secondary, and therefore can be a sign of many diseases.

Clinical manifestations

white blood cells during pregnancy

Leukocytes during pregnancy are determined by laboratory and evaluated over time

In 75% of clinical cases, leukocytosis during pregnancy is asymptomatic, detected only in the laboratory. Considering that leukocytes indicate an infectious process of varying severity, the symptoms depend on the characteristics of the underlying disease:

  • headaches, dizziness, fainting;
  • fever (from subfebrile condition to severe hyperthermia, when the number of leukocytes is significant);
  • lethargy, malaise;
  • signs of intoxication – nausea, vomiting;
  • decreased vision;
  • pain in the lower abdomen;
  • shortness of breath, difficulty breathing;
  • excessive sweating.

With nephrourological problems, dysuric disorders, an increase in leukocytes in the urine, and painful urination are observed. When typical symptoms of cystitis, urethritis, vulvovaginitis appear, an extensive diagnosis should be made.

With physiological leukocytosis, there are no characteristic symptoms, but slight malaise, fatigue, weakness are possible. The persistent appearance of disturbing symptoms requires mandatory monitoring by specialists.

Dangerous symptoms are severe abdominal pain, fever for more than 2-3 days, fainting, profuse vomiting, acute back pain, blood or pus in the urine. In case of depression of consciousness, urgent hospitalization is necessary in the department of pathology of pregnant women or another appropriate profile.

Reference values

The norm is when leukocytes in laboratory samples are absent or are in minimal quantities in the field of view. Normal leukocyte counts in the analyzes of a healthy adult vary between 4.4–10.0 × 10 * 9 units / l. A relatively stable level should be maintained throughout the entire gestation period. Depending on the timing, the following norm options are allowed:

  • the beginning of pregnancy – the reference varies within 4.3–9 × 10 * 9 / l;
  • diagnostics in the II trimester – a slight increase in indicators is acceptable due to an increase in systemic immunity, an increase in the functioning of the circulatory system;
  • study in the III trimester – reference values vary within 11–15 × 10 * 9 / l.

With persistent preservation of the level of leukocytes at the upper limit of the norm, additional laboratory tests are prescribed. Be sure to take into account the criteria of anamnesis, age, nature of the course of pregnancy. With multiple pregnancy, an increase to 12–16.5 × 10 * 9 / l is permissible.

The rate of leukocytes in the blood

norm

The rate of leukocytes is determined depending on the biological material under study

The average values of leukocytes during pregnancy are in the range of 4–9 units per field of view. The basic criteria underlie the tactics of managing the patient. An increase indicates various inflammatory diseases, so it is important to find out the true cause of the deviation from the norm in a timely manner.

Increase in white blood cells in the urine

Laboratory examination of urine is carried out several times. With a complicated history of the disease, control is often required at least 2-3 times a month. An increase in leukocytes is indicated by exceeding the reference limit of 0–3 units in the field of view. An insignificant amount of cells in the field of view may indicate an incorrect sampling of biological material for research. In 90% of clinical cases, a persistent increase is the result of urinary infections, inflammation of the kidneys of any intensity and nature.

In order to avoid false-positive results and re-testing at elevated rates, a thorough toilet of the external genitalia is required, as well as timely delivery of the sample to the laboratory. The number of leukocytes during pregnancy does not characterize the condition of the fetus.

A smear for the study of vaginal microflora

Analysis is taken before pregnancy planning, during obstetric registration and in case of atypical symptoms during the gestational period. In a vaginal smear, the content of leukocytes should not exceed 10 units per field of view. With an increase in indicators, genital tract infections are suspected, which were in remission before pregnancy: colpitis, vaginitis, genital infections, thrush. An increase in performance is not the norm, so the doctor prescribes additional treatment.

It is important to understand that any deviation from the norm, even a slight one, can affect the course of pregnancy and pose a threat to the growing fetus. Women should follow all medical recommendations, take routine tests, and undergo treatment.

Treatment tactics

Treatment of leukocytosis during pregnancy is prescribed carefully. It is important to take into account the level of high rates, the degree of the inflammatory process, the nature of pregnancy. With elevated rates, according to studies of the vaginal microflora, they are limited to local therapy or observation. Usually, after childbirth, the vaginal microflora returns to normal. In other cases, the following drugs are indicated:

  • antibiotics;
  • uroseptic preparations for inflammation of the kidneys, organs of the urinary system;
  • immunomodulators to increase local and systemic immunity.

In the treatment of this condition in women, herbal preparations are preferred to minimize side effects and risks to the growing fetus. The total duration of treatment is 7-14 days, after which a control analysis of the vaginal secretion and other biological fluids is shown. In severe cases, therapy is carried out in a hospital setting.

Preventive actions

An increase in leukocytes in the analysis of biological fluids can be prevented by following simple clinical recommendations:

  • sexual contact using a condom;
  • frequent and adequate hygiene of the genitals;
  • exclusion of bad habits;
  • protective regime, prevention of hypothermia, colds;
  • timely treatment of viral infections;
  • adequate asepsis of pustular foci on the skin, mucous membranes.

In the early stages of gestation, it is important to sanitize the oral cavity in order to exclude periodontitis, periodontitis, deep caries, and stomatitis. Pregnancy reduces a woman’s immunity, so even minor inflammatory foci can lead to the spread of infection throughout the body.

Complications and prognosis

Complications of leukocytosis are significant if the condition is caused by serious inflammatory diseases of the internal organs, purulent processes. Among the negative consequences are:

  • placental insufficiency;
  • premature birth, early miscarriages;
  • uterine bleeding;
  • pathologies and anomalies in the development of internal organs, fetal systems;
  • chronic inflammatory diseases.

The prognosis for leukocytosis during gestation in pregnant women is mostly favorable if the patient undergoes regular examinations, tests, and follows the recommendations of doctors. In the absence of treatment or inadequate therapy against the background of the inflammatory process, the risks of adverse effects increase.

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