Why leukocytes in urine are elevated in pregnancy

Leukocytes in urine during pregnancy is an increase in the level of leukocytes above the norm, which can be caused by various reasons. Most often, a significant increase in the level of leukocytes by two or more times is caused by an inflammatory process of the urinary or genital tract. But there may also be a normal deviation in the level of leukocytes under certain conditions. Therefore, you need to know such "symptoms of alarm" in order to prevent the development of complications of pregnancy and childbirth in time.

Causes leukocyturia in pregnancy

To know the reasons for the increase in the level of leukocytes, it is necessary to understand the role of these cells in the body and what are the standards for these indicators. Leukocytes are blood cells that are white and have different shapes, depending on their type. These cells act as protective forces, so an increase in these cells in the blood indicates the activation of the immune system. The structure of leukocytes allows them to penetrate through the cells and tissues of the body, which helps to implement their function in any place. Under normal conditions, leukocytes pass through the renal filter only in the form of single cells, which does not indicate inflammatory changes. The norm of immune cells in the urine of a pregnant woman may be higher than in other women. This is due to the fact that during pregnancy and an increase in the uterus, the topic of the urinary tract changes. Therefore, due to the physiological compression of the urinary tract, leukocytes can accumulate there, which are excreted in the urine. The standard values of inflammatory cells in urine are 0-4 cells in the field of view. During pregnancy, this indicator can reach 6 cells in the field of vision, but if the figure is significantly higher, then you should begin an examination or, at a minimum, consult a doctor.

The level of leukocytes in urine analysis is very important and if it is 4-6-10, then we can say that this is an acceptable level, but it is necessary to retake it. Such a number does not indicate a disease, and the reason for such an increase can only be that the woman did not take the test according to the rules or in an unclean container. Therefore, it is necessary to repeat the test, observing all the rules of hygiene. It is necessary to take a urine test in the morning, after thorough hygiene procedures. It is very important that the container is clean - therefore it is better to buy a glass for tests at the pharmacy. This will eliminate all possible subjective reasons for the increase in the level of leukocytes.

If the level of leukocytes in the initial analysis exceeds the norm by three or more times, then it should be considered that this is a symptom of inflammation. The process can be localized in the kidneys, bladder, ureters, and also genitals.

One of the reasons for the increase in leukocytes is pyelonephritis. This is a disease characterized by inflammation of the renal pelvis and calyces and the formation of inflammatory secretion. This is accompanied by the expansion of the system, accumulation of secretion and migration of leukocytes to the site of inflammation, as the main immune cells. Therefore, in addition to the clinical manifestations of pyelonephritis, there is the release of leukocytes in the urine due to their large number in the focus of infection. Also, one of the reasons for the release of leukocytes in the urine can be chronic pyelonephritis. Then the release of leukocytes is constant, and this can be the only symptom that is determined in the laboratory.

Another reason for the frequency of leukocyturia symptoms is acute cystitis. This is an inflammation of the bladder, which is caused by pathogenic bacteria and is also accompanied by active migration of leukocytes. The symptoms of cystitis development are very fast and are characterized by the appearance of leukocytes at the beginning of the disease, which is due to the close location of the bladder. The pathogenesis of the development of inflammatory diseases during pregnancy is associated with significant compression of organs by an enlarged uterus. This contributes to the active development of the inflammatory process.

The cause of increased leukocytes in urine may also be inflammation of the genitals. Acute vulvovaginitis is an inflammation of the vagina, which often develops in pregnant women against the background of a decrease in immune status. The disease is characterized by an increase in the number of leukocytes, as well as other clinical manifestations.

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Risk factors

Based on the possible causes of the pathology, it is necessary to identify risk factors that must be taken into account when diagnosing and planning pregnancy. Women with chronic pyelonephritis have a direct risk of exacerbation of this pathology during pregnancy. Also at risk are women who often suffer from cystitis, who have reduced immunity and resistance.

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Symptoms leukocyturia in pregnancy

Clinical signs of pathologies that cause an increase in leukocytes in urine may develop even before changes in the tests appear. Therefore, it is necessary to pay attention to the symptoms that occur before this. The situation may be the opposite, and leukocyturia may be the first and only symptom of the disease.

Acute pyelonephritis is more common in the third trimester of pregnancy, when the enlargement of the uterus and increased synthesis of progesterone stimulates a violation of the anatomical structure of the urinary tract. Therefore, acute pyelonephritis in a pregnant woman is called gestational, and has a secondary obstructive nature. Against the background of a violation of the normal outflow of urine, conditions are favorable for the development of pathogenic microorganisms. The first signs of pyelonephritis can manifest themselves in the form of a significant increase in body temperature. Most often, this happens at night, when a woman feels a headache, poor general health and a temperature rises above subfebrile numbers. Pain in the lower back or just in the lower back is also felt. The pain is not constant, but it is pronounced and causes acute sensations. This can be accompanied by urination disorders - pain or discomfort, frequent urge to urinate, cloudy urine. These are the main symptoms of pyelonephritis, the appearance of which should make you see a doctor.

Chronic pyelonephritis during pregnancy can worsen, then all the symptoms characteristic of acute pyelonephritis appear. But sometimes the chronic process may not worsen, then there are no objective symptoms, except for changes in the tests. Therefore, it is so important to conduct dispensary observation of pregnant women with chronic pyelonephritis.

Acute cystitis is characterized by rapid development of symptoms after hypothermia. By evening, symptoms of discomfort and a pulling sensation in the lower abdomen above the pubis appear. Frequent urges to urinate and burning and pain during this are characteristic symptoms of cystitis. Body temperature does not rise and is a distinctive feature of cystitis and pyelonephritis.

Acute vulvitis or vulvovaginitis is accompanied by an inflammatory process directly in the vagina. Therefore, the main symptom of the disease is purulent or cloudy discharge from the vagina, as well as itching and burning sensations in the vagina. And the appearance of any discharge can be a manifestation of local inflammatory processes of the genitals.

Leukocyturia may not be the only manifestation. Leukocytes and bacteria in the urine during pregnancy mainly indicate an acute inflammatory process - pyelonephritis or cystitis. Bacteria can be direct pathogens of infection.

If leukocytes and erythrocytes are detected, this may be a serious symptom of acute kidney pathology with damage to the nephrons. Glomerulonephritis is an inflammation of the kidneys with damage to the glomeruli, which is accompanied by the appearance of leukocytes in the urine due to impaired renal filtration. The disease develops gradually and can manifest itself as increased blood pressure, edema, and intoxication syndrome. If the erythrocytes are fresh, this may be a symptom of kidney damage, trauma, or urolithiasis. Therefore, it is important to conduct a comprehensive differential diagnosis when leukocyturia and erythrocyturia appear.

Protein and leukocytes in the urine during pregnancy can be a symptom of serious late gestosis. Late gestosis develops in the third trimester of pregnancy and the first clinical manifestations can begin with swelling of the legs. Then symptoms of increased blood pressure and symptoms from the fetus can join. This pathology - preeclampsia, is caused by massive release of protein, changes in the oncotic pressure of the blood and corresponding symptoms.

The many reasons for the appearance of leukocytes in the urine of expectant mothers indicate that it is necessary to conduct a thorough diagnosis, especially for expectant mothers.

Complications and consequences

The consequences of leukocyturia can be very serious if the cause is acute pyelonephritis. In pregnant women, the inflammatory process in the kidneys, if not diagnosed in time, can cause acute anuria or the formation of a kidney abscess. Complications that can develop against the background of an intense inflammatory process include infection of the fetus and the possible development of intrauterine infections and congenital defects.

If leukocytes appear against the background of preeclampsia in a pregnant woman, complications can be very serious in the form of arterial hypertension and the development of eclampsia. This can be accompanied by convulsions, which also poses a potential threat to the fetus.

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Diagnostics leukocyturia in pregnancy

If the level of leukocytes in the urine of a pregnant woman reaches 4 to 10 in the field of view, then it is certainly too early to talk about a diagnosis, but it is necessary to conduct a repeated urine test. If the result is the same or higher, then it is necessary to carefully examine the woman and conduct a thorough differential diagnosis. If the repeated result is within the normal range, then the changes were due to an incorrect technique for taking the test.

A pregnant woman takes tests regularly during pregnancy precisely to detect the disease in time before symptoms appear. Urine analysis is included in the list of mandatory tests and is performed once a month in the first trimester, twice a month in the second trimester and every week in the third trimester. If changes are found in a woman during a routine urine test and there are no objective symptoms, then in this case it is necessary to begin diagnostics by collecting anamnesis and examination of systems. It is necessary to clarify with the woman about the presence of chronic diseases, kidney diseases. It is important to ask about previous pregnancies and the presence of late or early gestosis. Then it is necessary to examine the woman, sometimes you can see swelling of the legs or swelling under the eyes, which may suggest kidney pathology. If a woman had an increase in body temperature, then it is necessary to check the Pasternatsky symptom, which is positive in the case of acute pyelonephritis. After an objective examination, it is necessary to carry out additional diagnostic methods to clarify the pathology and exclude a threat to the life of the baby.

The tests should exclude a pathological condition or determine the source of infection if inflammation is suspected. A general blood test helps to exclude an inflammatory process, otherwise, there will be leukocytosis and a shift in the formula to the left in acute pyelonephritis or in the exacerbation of chronic pyelonephritis. A general urine test helps to establish the function of the kidneys and urinary tract. Any increase in leukocytes may indicate inflammation and possible cystitis or pyelonephritis. In the case of cystitis, changes will only be in the urine test, and the blood test will be normal. If a woman has pyelonephritis, there will be changes in the blood and urine. In addition to leukocyturia, a urine test may have minor proteinuria, epithelium and bacteria. If, in addition to leukocytes, massive proteinuria is determined, then preeclampsia can be considered, which is very serious in terms of possible complications.

Instrumental diagnostics must be carried out in order to exclude acute conditions. Ultrasound examination allows to accurately determine the condition of the fetus, the localization of the ovum and to accurately exclude one or another condition. Acute pyelonephritis can be accurately diagnosed using ultrasound - expansion of the renal pelvis is an objective symptom of inflammation. The presence of stones in the renal pelvis can also accurately diagnose and establish urolithiasis. If preeclampsia is suspected, it is necessary to monitor blood pressure. Other methods of instrumental examination can be used for the purpose of differential diagnostics. If necessary, a Doppler study is performed to study the fetus's blood circulation and study its reaction to the mother's disease.

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Differential diagnosis

Differential diagnostics of leukocyturia should be performed to exclude an acute condition that threatens serious complications of pregnancy. For example, preeclampsia can quickly develop into a convulsive syndrome. Therefore, it is necessary to examine the woman and differentiate a transient increase in leukocytes in the urine from gestosis. It is also necessary to exclude an exacerbation of chronic pyelonephritis and acute pyelonephritis, since approaches to treatment are different.

Treatment leukocyturia in pregnancy

Treatment is used with mandatory consideration of the etiologic factor and only after a thorough examination. It is necessary to consider the potential harm to the child during any treatment of a woman. If the cause is gestational acute pyelonephritis, then complex treatment with mandatory hospitalization is used. In pregnant women, pyelonephritis is secondary due to the fact that the uterus compresses the ureters, so stenting with restoration of urine outflow is a mandatory element of treatment. Then you need to prescribe an antibiotic that can be used by pregnant women. Such approved antibacterial agents include unprotected aminopenicillins and cephalosporins.

1. Ampicillin is an antibiotic from the group of unprotected penicillins, which have activity against gram-positive and some gram-negative microorganisms, which play a key role in the development of pyelonephritis. The drug is active against Escherichia coli, Haemophilus influenzae, Klebsiella, Shigella, Salmonella, Proteus. The drug acts by disrupting the cell wall and easily lysing it, which leads to the death of the parasitic microorganism. The drug has no teratogenic effect, but can penetrate with milk in small quantities. The method of using the drug for acute pyelonephritis is parenteral, which accelerates the effect and action of the substance at the site of infection. The dosage of the drug is 0.5 g four times a day. Side effects can be frequent in the form of allergic reactions, as well as effects on the nervous system.
2. Cefpodoxime is a third-generation beta-lactam antibiotic, especially effective against aerobic flora. The drug has a bactericidal effect on possible pathogens of chronic and acute infections, so it can also be used for cystitis. The dosage of the drug is 200 milligrams twice a day, for at least ten days. Side effects are possible, both allergic and dyspeptic.
3. Canephron is a complex herbal preparation that is very effective in the treatment of acute and chronic diseases of the urinary system. It contains centaury, rosemary, and vitamins, so the drug is completely safe for a child. Treatment can be carried out for acute cystitis or its frequent episodes. The medicine should be taken with a sufficient amount of liquid and monitor the blood pressure of a pregnant woman. Method of administration in tablets or drops. Dosage - two tablets three times a day. Side effects are rare - a drop in blood pressure, headache, dizziness, nausea, allergic reactions.
4. Amazhestin is a herbal preparation that has antibacterial, anti-inflammatory and diuretic effects, which allows the drug to be used to treat urinary tract infections. The drug contains a dry extract of bearberry leaves. The method of using the drug in the form of tablets, without chewing and with a sufficient amount of water. The dosage is two tablets three times a day, treatment should be carried out for no more than one week. Side effects are rare, allergic reactions are possible.

Vitamins can be used by the expectant mother throughout the pregnancy, or in case of an acute illness – after recovery. Many vitamins normalize the state of the woman’s immune system after an illness, and also strengthen the walls of blood vessels, which improves blood flow in the kidney. Therefore, it is possible to recommend taking complex vitamin preparations during the recovery period.

Physiotherapy treatment can be used for cystitis, but in the absence of contraindications. It is necessary to take into account the condition of the fetus and in the early stages to take any procedures only on the recommendation of a doctor and in the absence of an acute inflammatory process.

Surgical treatment of pathologies that are accompanied by the appearance of leukocytes in the urine can be used only if there are complications against this background. Sometimes, with urolithiasis and acute anuria, it is necessary to perform surgical intervention to apply a nephrostomy. In the case of an advanced purulent process, it may be necessary to surgically remove purulent foci.

Traditional methods of treatment

Traditional medicine is very effective together with the elimination of the inflammatory process using antibacterial therapy. The main effect of traditional methods is the use of agents that have a diuretic and antiseptic effect, which accelerates the elimination of pathogenic microorganisms.

1. Birch sap contains many microelements and phytoncides, which help remove metabolic products and relieve inflammation in the kidney area. For a therapeutic effect, it is recommended to take a glass of fresh birch sap in the morning - this will improve blood circulation after a night's sleep.
2. Hibiscus tea with cranberries is an excellent remedy for the treatment of urinary tract pathologies, since tea leaves and cranberries have not only an anti-inflammatory but also an antispasmodic effect, which improves the flow of urine. You need to drink tea at least twice a day.
3. Flax is a remedy that actively cleanses the kidneys and promotes the regeneration of epithelial cells of the urinary tract. For a cleansing infusion, take thirty grams of flax seeds, pour boiling water over them and leave for two hours. Then dilute the solution in a one-to-one ratio with warm water. Drink the medicinal infusion one tablespoon at a time five times for at least three days.

Herbal treatment is very effective in kidney and bladder pathology, but it is necessary to exclude gestosis in a woman, since additional water load can be very harmful and lead to complications. In any case, taking medicinal teas should be done carefully, monitoring the condition of the pregnant woman and possible edema.

1. Bearberry leaves are an excellent remedy for treating kidney pathology. To prepare the infusion, pour 30 grams of bearberry grass with cold water and leave for three days. Then, before use, strain the decoction and boil it, only then can you take twenty grams in the morning and evening.
2. A very useful kidney tea made from lingonberries, chamomile, currant leaves and corn silk. This tea has a diuretic and anti-inflammatory effect. You need to take 50 grams of each ingredient, make tea from two liters of water and drink it in small sips throughout the day. The course of treatment is four weeks, while monitoring the total amount of fluid that is excreted.
3. An infusion of cornflowers, lovage and St. John's wort is known for its beneficial effect on the urinary tract, so this remedy can be used for urolithiasis and spasmodic urinary outflow disorders. The infusion can be made by boiling the herbal leaves in hot water for ten minutes, and then after it cools down, take a shot of the solution twice a day.
4. Lingonberry and strawberry are plants that reduce inflammation in the bladder, renal pelvis and reduce the tone of the ureters, which improves the dynamics of urine in a pregnant woman and thus speeds up recovery. The medicine is also used in women with chronic pyelonephritis in the form of an infusion to prevent exacerbations. For tea, you need to take 30 grams of grass and berries of both bushes, pour hot water and leave for ten minutes. Then, before use, strain the decoction and take twenty grams in the morning and evening.
5. A herbal infusion of coltsfoot, chamomile and cornflower leaves is very effective in acute pyelonephritis as an antiseptic. For medicinal tea, take twenty grams of each herb, pour into a thermos and fill with hot water, leaving overnight. Drink fifty grams of tea warm.

Homeopathy can also be used, especially in women at risk, before symptoms appear.

1. Baptisia is a homeopathic remedy of plant origin, which is effective in the treatment of inflammatory pathology of the kidneys and chronic inflammatory process of the bladder. The drug has very strong antiseptic properties and is used in the form of a tincture. Dosage - three drops every day. The course of treatment can be started immediately after the appearance of complaints, and before childbirth, you can stop taking the drug. Side effects can manifest themselves in bowel dysfunction.
2. Aconite is a plant used to treat kidney pathology in the sixth dilution. The drug is especially effective in treating women with a strong temperament, with rapid pulse and heartbeat. The method of administration of the drug is enteral and the dosage begins with one granule every three hours on the first day, then you need to take two granules every six hours the next day, and from the third day, four grains twice a day. The prophylactic dose can be started at half the therapeutic dose from the first trimester of pregnancy. Side effects may be on the first day of administration in the form of increased nagging pain in the lower abdomen, which passes after a few hours.
3. Solidago is a homeopathic medicine used to treat kidney disease, which is accompanied by severe leukocyturia and prolonged temperature reaction. The medicine is dosed four drops in the morning and evening, the method of application is to dissolve the drops in a large amount of water. Side effects may occur at a high dose - dizziness, headache, general weakness appear.
4. Apis is a remedy for the treatment of pyelonephritis in the first trimester with ascending infection of both the kidneys and the bladder. It is available in the form of drops and is used in a dosage of three drops per dose. Method of application - the solution should be diluted with boiled water and drunk after meals. The course of treatment is two drops twice a day. Side effects are rare, allergic skin reactions are possible.
5. Kapisicum is the most effective remedy for acute inflammatory processes in the kidneys in late pregnancy. This homeopathic medicine acts in the third dilution on the dynamics of the inflammatory reaction and its rapid resolution. It is available in the form of drops and is used in a dosage of three drops per dose. Method of application - the solution should be diluted with boiled water and drunk after meals. The course of treatment is two drops twice a day, and then after a month you can increase the dose to three drops, as the pregnancy period increases. Side effects are rare.

Traditional and homeopathic methods of treatment can be used only after consultation with a doctor.

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Prevention

Prevention of any disease is very important for the expectant mother, especially if the woman takes preventive measures at the stage of pregnancy planning. Women with chronic pyelonephritis need to be carefully examined and, if necessary, treated, since the likelihood of exacerbations is very high. The same applies to women from the risk group.

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Forecast

The prognosis for recovery even in acute inflammatory processes is favorable, with adequate and timely treatment. The prognosis for normal labor and the birth of a healthy child is also favorable, since kidney pathology is easily corrected without harm to the baby.

Leukocytes in urine during pregnancy - this most often indicates acute pyelonephritis or cystitis, but it is necessary to take into account other manifestations. It is worth excluding late gestosis if leukocytes are determined together with protein, since this is the most threatening condition during pregnancy. In any case, in order to avoid taking antibacterial drugs during pregnancy, it is necessary to prevent pathology in women from the risk group.

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