Leukocytes in Urine During Pregnancy
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Your developing baby is going to demand a lot from your body and to make sure that your baby is growing and developing in the right manner, you will have to visit the doctor for regular check-ups. Many tests will be performed during every visit; however, one of the tests that you will need to take at every check-up is a urinary test. This test can help detect the level of leukocytes or white blood cells in the urine, which can help the doctor confirm infections, if any, that could need treatment, and avoid further medical complications. In this article, we will talk about what leukocytes are, what causes them, and the treatment available to balance their level.
What Are Leukocytes in Urine?
Leukocytes are white blood cells that are present in the immune system. They help defend the body from infections and diseases. When they appear in the urine, it mostly indicates infection in the kidneys and the urinary system. A rise in the level of leukocytes in the rest of the body also indicates infection.
The average level of leukocytes that should be present in the urine is between 2 to 5 WBCs/hpf. However, if the level of leukocytes rises and goes above 5 WBCs/hpf, it may be a sign of an infection that must be investigated and treated.
What Causes Leukocytes in Urine During Pregnancy?
The number of white blood cells increases in the urine in pregnant women due to one of the following reasons:
1. Urinary Tract Infection
Urinary Tract Infection or UTI is the most common cause of leucocytes in pregnancy. It occurs due to the physiological changes that pregnancy leads to. Leukocytes are usually present in the urine if you are suffering from UTI. When a woman is pregnant, there is an increase in the bladder volume, but the tone will be reduced due to increased levels of the hormone ( estrogen and progesterone ) along with dilatation of ureters
It is very difficult in this situation to completely empty the bladder, and so the bacteria may never fully leave the system. Instead, it multiplies, causing an infection.
2. Asymptomatic Bacteriuria
When there are bacteria in the urine and the patient doesn’t have any symptoms, it is called asymptomatic bacteriuria.
About 30% of pregnant women may have a bacterial infection in the urinary tract but show no symptoms. These can cause leukocytes to manifest in the urine. If left unchecked in pregnant women, this causes pyelonephritis (infection of the kidney), and therefore, it is important for doctors to perform a routine urine test.
3. Genital Infection
Sexually and non-sexually transmittable infections may lead to the presence of white blood cells in the urine of a person. Some of the infections that can cause leukocytes to appear in the urine of pregnant women are Chlamydia, vaginal yeast infection, bacterial vaginitis, gonorrhoea and genital herpes.
4. Kidney Infections
Kidney infections, or pyelonephritis, develops when an infection of the urinary tract is left untreated in pregnant women. This is a serious condition that must be treated at the earliest to avoid preterm labour or premature rupture of the membranes. Kidney infections can cause leukocytes to appear in the urine and may cause fever, lower back pain and vomiting.
Pregnant women suffer more from this due to the physiological changes during pregnancy, and as the foetus grows, it puts more pressure on the kidneys further increasing chances of infection.
This is a type of urinary tract infection that leads to the bladder becoming inflamed and causes the number of white blood cells in the urine to rise. It is caused by a bacterial infection and has symptoms similar to UTI, but there is also lower back pain and discomfort in the pelvic region. If the inflammation is severe, traces of blood are found along with leukocytes in the urine.
Signs and Symptoms of White Blood Cells in Urine While Pregnant
Most often, the signs and symptoms will vary depending on what is causing the rise in leukocyte levels. Some of the main symptoms of leukocytes in urine during pregnancy are:
(please verify all the points above)
- Burning sensation while urinating
- Frequent urination
- Unable to empty the bladder
- Foul-smelling urine
- Cloudy looking urine
- Lower back pain
- Weakness and fatigue
- A low fever
- Nausea and vomiting
One of the top causes for an increase in the level of leukocytes is urinary tract infection. Other than the symptoms that a pregnant woman would experience, there are other means of diagnosing the levels of leukocytes in urine. Read on to know about how the diagnosis is carried out.
1. How to Measure the Level of Leukocytes
A urine routine microscopy along with urine culture and sensitivity should be done to see if any bacteria are present in the urinary system.
Pregnant women are allowed an increase in leukocytes by 4 to 5 wbc/hpf, only if all other indicators remain unchanged. An increase above 5wbc/hpf indicates that there is most likely an inflammation somewhere in the urinary system or the kidneys.
2. How to Analyse
During the first trimester, the urine routine and microscopy tests are done every three to four weeks. During the second trimester, it is done every two weeks, and by the third trimester, it is done every week. The analysis will require the first urine of the morning to be collected in a jar that has been sterilised to avoid contamination of the sample. Your doctor will also need to know all about your medical history, any medications that you are currently on, and your symptoms to identify what the cause.
3. Instrumental Diagnosis
This is usually an ultrasound where the bladder, urinary tract, and kidneys are studied. Any enlargement in the pelvic region will be clearly visible in the scan. Ultrasounds can detect the neurogenic bladder, polycystic kidney disease, kidney stones, and obstructive uropathy.
4. Differential Diagnosis
In this, clinical analysis of the urine is done where any increase of white blood cells can be seen. These analyses are compared with that of a woman’s general condition and her complaints. An anamnesis is available to help identify the cause of the condition. A process called urine culture and sensitivity is carried out to identify the main pathogen and select the right therapy. This process delivers accurate results.
After the analysis is done, it is imperative that the treatment is started immediately to avoid any pregnancy-related complications. We shall talk a little bit about that in the article here on.
Effects and Complications
As mentioned earlier, treatment must commence immediately if you have been found with high levels of leukocytes in urine, and the doctors have determined the cause. If, for example, you have been found to have pyelonephritis, which is a kidney inflammation caused by a bacterial infection, your doctor will prescribe certain antibiotics that should be taken while carefully following the instructions to avoid further complications in pregnancy.
Eclampsia is another condition that may arise due to high levels of leukocytes in urine, and it causes a rise in blood pressure. Careful monitoring of your condition during pregnancy can save your baby’s life by avoiding the development of serious complications.
If the diagnosis suggests cystitis, it may turn serious and result in painful urination. Further development of this can turn into gangrenous cystitis, where the pain will be intense, and there is a complete inability to urinate, putting your bladder and peritonitis at risk of rupturing.
Some infections will leave behind a residue of stone as well in the kidney. It is, therefore, highly important to treat any problem at the earliest to avoid some very unpleasant and dangerous complications. Let’s take a look at some ways to treat leukocytes in the urine.
How to Treat Leukocytes in Urine
There is no fixed method of balancing or decreasing levels of leukocytes in the urine. The treatment will vary depending on the individual’s leukocyte levels and will be based on the diagnosis. Here are some of them:
1. Natural Disinfectants
If the inflammation is not serious, it can be treated with natural disinfectants and diuretics. Most pregnant women will be advised to drink cranberry juice and lots of water.
The urine will be encouraged out of the body with these, decreasing the chance of developing more serious infections.
If the inflammation is more serious, antibiotics will need to be administered, but you must ensure that the doctor prescribes antibiotics that are safe for your baby as well. Antibiotics can help eliminate the infection and prevent more serious complications during pregnancy.
If you have an obstruction such as kidney stones that are causing the rise in leukocyte levels, you will most probably need surgery to remove the obstruction. Drink plenty of water to try and get rid of the smaller kidney stones, though passing it naturally is quite painful.
4. Sound-Waves, Chemotherapy, and Radiation
For larger kidney stones, sound waves can be used to break them up.
So, what can you do to prevent Leukocytes in urine during pregnancy? Read on to know more.
Here are some ways to prevent the rise of leukocytes in the urine:
- Go for regular urine tests.
- Drink lots of water to flush out the bacteria and toxins from the body.
- Urinate often and regularly.
- Maintain personal hygiene by washing your hands before you use the restroom, as well as by keeping your genitals clean after you have relieved yourself.
- When wiping, wipe from front to back.
Here are some frequently asked questions about the occurrence and rise in the levels of leukocytes in urine:
1. Can Increased White Blood Cells in Urine Indicate Blood Leukemia?
No, increased white blood cells in urine never indicate leukaemia.
2. Can Elevated Number of WBCs in Urine Lead to STD Infection?
White blood cells in urine can never be the cause of STDs, STDs are caused by chlamydial infections.
3. Can Leukocytes in Urine Cause Foetal Death If Left Untreated?
There are cases where the rise in the number of leukocytes in the urine is associated with late toxicosis and other rather serious inflammatory problems. Pregnant women who have these conditions are plagued with fatigue and increased pressure on their bladder. They are also at risk of losing the baby due to chances of preeclampsia.
If the leukocytes esterase in urine during pregnancy, and the inflammation is detected on time, then there is no risk, but if left untreated, there are high chances of complications during childbirth.
One of the most important things to follow during pregnancy is to identify and treat any rise in the levels of leukocytes in the urine. If this is not done, it can have a very negative impact on your health and the life of your unborn child. Often, the abnormal WBC count will be noticed at the earliest as routine urinary tests are a part of the general check-ups for pregnant women. But, if treatment is not followed regularly and care is not taken, the situation can worsen. So, make sure you don’t miss any of your prenatal check-ups and follow your doctor’s instructions carefully.
Also Read: CBC (Complete Blood Count) Test in Pregnancy