Leukocytosis during pregnancy
(ICD-10 classification R70-R79) is a condition of the body in which the concentration of white blood cells (leukocytes) in the bloodstream increases. Every pregnant woman regularly undergoes a blood test, which shows not only the hemoglobin level, but also the number of leukocytes - it is important that the leukocytes in the blood are not increased or decreased, as this is evidence of pathology. Normally, the level of white blood cells can fluctuate from 4 to 8.8 × 109/l, but in pregnant women it is considered normal to increase leukocytes in the blood to 11 × 109/l.
A slight increase in the number of white blood cells during pregnancy indicates activation of the immune system, an increase in the erythrocyte sedimentation rate and slight thickening of the blood. In cases where leukocytes in the blood increase significantly, leukocytosis develops, which indicates the presence of inflammatory processes or other pathologies in pregnant women that require immediate treatment.
Causes of leukocytosis
Leukocytosis can develop in pregnant women for various reasons. The most common causes of such a disorder are: acute respiratory viral infections, acute respiratory infections and other inflammatory diseases that a woman could contract during pregnancy; severe pathologies, such as viral pneumonia or chickenpox, dangerous not for the woman herself, but for the child in her womb; an allergic reaction to certain medications prescribed by a doctor; receiving injuries, burns and other traumatic injuries (scratches with suppuration, abscesses, fractures and others).
Also, the reasons that a woman has developed leukocytosis may be associated with severe processes in her body, for example, with the disintegration of malignant tumors or internal bleeding. In some cases, pregnant women develop leukocytosis against the background of increased psycho-emotional stress. Therefore, doctors recommend that pregnant women avoid stress, as well as physical and mental fatigue. Classification of leukocytosis Sometimes leukocytosis is physiological and not pathological, that is, it occurs as a reaction to the action of certain environmental factors.
Treatment tactics
Treatment of leukocytosis during pregnancy is prescribed carefully. It is important to take into account the level of high indicators, the degree of the inflammatory process, and the nature of pregnancy. If the indicators are elevated, according to studies of vaginal microflora, local therapy or observation is limited. Typically, after childbirth, the vaginal microflora returns to normal. In other cases, the following drugs are indicated:
- antibiotics;
- uroseptic drugs for inflammation of the kidneys and urinary system;
- immunomodulators to enhance local and systemic immunity.
In the treatment of this condition in women, preference is given to herbal-based drugs 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 vaginal secretions and other biological fluids is indicated. In severe cases, therapy is carried out in a hospital setting.
Elevated leukocytes during pregnancy: possible causes
Leukocytosis may be of a physiological nature; such an increase in leukocytes is not a sign of the presence of any disease.
An increase in the number of leukocytes in the blood occurs:
- For stress and anxiety
- During the second trimester of pregnancy
- After taking a hot bath
- Three hours after eating
To avoid false test results, blood must be taken strictly on an empty stomach in the first half of the day, and during blood collection the patient must be as relaxed and calm as possible.
More dangerous causes of leukocytosis may include:
- Bacterial or viral infection. This may be an infectious disease of the respiratory tract - pneumonia or bronchitis. Typically, such diseases are accompanied by fever and cough. Acute bacterial infection is also possible - appendicitis, pyelonephritis and others.
- Inflammatory processes occurring in the body. For example, during exacerbation of chronic gastritis or arthritis, the level of leukocytes in the blood may increase.
- Various skin injuries, burns and so on.
- Allergic reactions or asthma.
- Development of various urogenital infections.
- Large blood loss.
- Malignant tumors, metastases.
All of the above diseases can have a negative impact not only on the expectant mother’s body, but also on the development of the fetus. Therefore, they require immediate initiation of treatment. The greatest danger of leukocytosis lies in its rapid development. Developing in just a few hours, leukocytosis can cause internal bleeding. It is for this reason that treatment of this disease should occur under the strict supervision of a doctor, who must first establish and eliminate its causes.
In medical practice, most often cases of leukocytosis in pregnant women are caused by slowly occurring inflammatory processes in the body, allergic reactions, uncontrolled use of medications, renal colic, as well as exacerbations of chronic diseases.
Another reason for the increase in the level of leukocytes in the blood is the accumulation of white blood cells in the submucosa of the uterus. This is a natural physiological process that is necessary in order to prevent any infection from reaching the fetus developing in the uterus, as well as to stimulate the contractile function of the uterus necessary during childbirth.
For example, white blood cells in pregnant women may increase if they take a bath that is too hot or too cold. Also, the number of leukocytes in the blood may increase due to errors in the diet of a pregnant woman, which requires the doctor to correct her diet. Engaging in heavy physical work can also provoke leukocytosis, but it is important to remember that such leukocytosis is shown by tests only if they are carried out in the near future after an external influence on a woman of an unfavorable factor.
If leukocytosis is detected in the blood of a pregnant woman after a long time after such exposure, we are already talking about a pathological condition. The most serious reasons that can cause an increase in the level of leukocytes in the blood of pregnant women are: abscesses; peritonitis; sepsis. These conditions are dangerous not only for the child, but also for the life of the mother, so if diagnosis is not carried out in a timely manner and treatment is not prescribed, the child in the womb of a pregnant woman and she herself may die.
A few words should be said about the reasons for the decrease in leukocytes in the blood of pregnant women.
These include:
- rubella;
- measles;
- malaria;
- tuberculosis;
- viral hepatitis
- and some other severe pathologies.
These diseases are dangerous in themselves, but their danger also lies in the fact that they can provoke the development of deformities in the fetus, as well as cause premature birth. Therefore, pregnant women are regularly examined for these viruses and infections - many of them are included in the examination for TORCH infections. Also, a low level of leukocytes in the blood can be observed when a woman is exposed to radiation, when her body is exposed to certain harmful chemicals, or when exhausted.
Rules for taking the analysis
In order for the analysis results to be reliable, the following rules must be observed:
- Leukocytes in the blood - normal by gender and age, increased and decreased values
- The day before donating blood, exclude fatty and spicy foods from your diet;
- Blood sampling is carried out on an empty stomach, before 12 noon;
- Before the study, avoid physical and emotional stress;
- Before blood collection, you should have a good night's sleep;
- 10-15 minutes before taking the test, you need to sit in a calm, relaxed atmosphere.
Diagnosis and treatment of leukocytosis
The number of leukocytes in the blood of pregnant women can be determined using a routine blood test. Treatment begins with establishing the cause of leukocytosis. To do this, sometimes it is necessary to conduct a complete examination of the woman. Once the diagnosis is established, the gynecologist who is caring for the woman’s pregnancy makes a decision regarding further treatment.
The drugs used must be harmless to both mother and child. But unfortunately, not in all cases it is possible to eliminate leukocytosis and the pathology that caused it without harming the health of the pregnant woman and the baby in her womb. Therefore, sometimes, in severe pathological conditions, the doctor may decide to terminate the pregnancy and save the life of the woman herself.
Preventive actions
Increases in white blood cell counts in body fluid tests can be prevented by following simple clinical guidelines:
- sexual contact using a condom;
- frequent and adequate genital hygiene;
- eliminating bad habits;
- protective regime, prevention of hypothermia, colds;
- timely treatment of viral infections;
- adequate asepsis of pustular lesions on the skin and mucous membranes.
In the early stages of gestation, it is important to carry out sanitation of the oral cavity in order to exclude periodontal disease, 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.
Reviews
Daria 05/10/2017
Girls, has anyone had it diagnosed during pregnancy? What consequences? Did they find the cause and were the leukocytes significantly elevated?
Ilyushina Mama 05/19/2017
They didn’t give me one, but they increased it 3 times. Then I read that this can happen during pregnancy
Elena Liukkonen 06/22/2017
From the beginning of pregnancy until the 22nd week, my leukemia was within 14. And then it sharply increased to 19 and the ESR also increased. The gynecologist ordered a test for c-reactive protein and it was normal. Then they said that there was an increase in leukemia and ESR during pregnancy, there was no inflammation.
Hat, 06/25/2017
Hello everyone! I’m writing straight from the hospital ward! On the 17th, I was admitted for preservation (28 weeks) with the threat of premature birth! They gave me magnesia for 5 days and injections for 7 days, and the rest of the time I’m just lying there without procedures! They don’t want to discharge me because . They say that I have an increased number of leukocytes (leukocytosis). There is no treatment for it and in response to all questions they yell that no one is keeping me here and I can leave, but they won’t pay me any money and won’t give me sick leave! I want to ask you about this leukocytosis, because I didn’t really find anything on the Internet! Thanks in advance.
Pyelonephritis as a cause of leukocyturia
For pregnant women, the development of pyelonephritis, an inflammatory kidney disease of an infectious nature, is especially dangerous. With pyelonephritis, the pathological process involves the glomeruli, renal pelvis, parenchyma, and tubular apparatus. Among pregnant women, 2-8% of women suffer from pyelonephritis. This is one of the main reasons for high blood pressure in women.
During pregnancy, there are many risk factors for the development of the disease:
- changes in a woman’s hormonal levels;
- pressure from the pregnant uterus on the bladder, which leads to the development of reflux of urine from the bladder to the kidneys;
- impaired innervation of the bladder with existing concomitant diseases (diabetes mellitus, damage to the nervous system)
In the presence of diabetes mellitus, the course of pyelonephritis can be complicated by urosepsis, the development of calciuria and result in death.
Complications of pyelonephritis
If inflammatory diseases of the bladder and kidneys are not treated in a timely manner, this can lead to the development of:
- late toxicosis (preeclampsia), which is very difficult and, in turn, causes various complications, including increased blood pressure and fetal death;
- eclampsia (one of the symptoms is an increase in blood pressure to critically high levels for both the mother and the fetus).
Any reason that causes an increase in leukocytes during pregnancy should not be ignored. The development of pathology in a woman during pregnancy can affect the health of the child and its development. In such cases, rapid diagnosis and gentle therapy are necessary. The expectant mother may have a reduced immune status; in such cases, the pathological process during pregnancy develops rapidly. This can lead to serious complications such as:
- development of congenital or chronic diseases in a child;
- premature birth;
- I'll miscarry.
Diagnosis of pyelonephritis
A woman with suspected pyelonephritis needs additional urine tests:
- according to Nechiporenko (determine latent leukocyturia, hematuria);
- according to Zimnitsky - determine the specific gravity of urine, which characterizes the concentration function of the kidneys;
- bacterial culture on various nutrient media to detect a specific pathogen;
- culture for sensitivity to antibiotics (until the results are obtained, the initial prescription of an antibacterial drug is empirical; even with such treatment, the effect occurs in 50% of patients);
- if necessary, blood tests for creatinine and uric acid (an increase in creatinine indicates the death of kidney nephrons);
- Sometimes an ultrasound of the kidneys is performed.
