Leukocytes in the urine of pregnancy – norms, symptoms, possible causes, treatment

Leukocytes in the urine of pregnancy are a clear signal that inflammation is taking place in the urogenital tract. There are many possible causes of leukocytes in urine during pregnancy, and their proper diagnosis is the only way to appropriate treatment during pregnancy. What are the norms of leukocytes in urine in pregnancy? When does the level of leukocytes in the urine increase and by what symptoms can this condition be diagnosed?

What are leukocytes?

Leukocytes are white blood cells, or morphotic parts of the blood. They are colorless and much smaller in number than red blood cells. The task of leukocytes is to protect the body against pathogens such as viruses and bacteria. Leukocytes should not appear in high concentrations in the urine.

If they appear in the urine, it means a disease developing in the urogenital tract, most often inflammation. The low amount of leukocytes in the urine is nothing to worry about. However, significantly exceeding the norm, especially during pregnancy, should be immediately consulted with a doctor, as it may endanger the health of the mother and the baby developing in her belly.

See: Leukopenia – causes, symptoms, diagnosis, treatment

Leukocytes in the urine of pregnancy – norms

Leukocytes in the urine of pregnancy may be present in small amounts. The permissible and acceptable norm of leukocytes in the urine of pregnancy is from 1 to 5 leukocytes in the field of view. If the test shows the presence of more than 10 leukocytes in the field of view, this is a sign of a medical condition and requires a visit to the doctor. Increasing the number of leukocytes in urine during pregnancy is called leukocyturia and usually requires further investigation.

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Leukocytes in the urine of pregnancy – causes

An increased amount of leukocytes in urine during pregnancy most often indicates the development of inflammation or infection. Very often, an increased amount of leukocytes is associated with inflammation of the urinary system or an ordinary infection. Urinary tract infections in pregnancy are very common, which is affected by the growing uterus and the growing baby in the mother’s belly. The pressure on the bladder prevents the bladder from emptying completely, which causes bacteria to develop and multiply in the accumulating urine in the bladder.

The presence of leukocytes in the urine of pregnancy is not an indicator that allows the doctor to make an unequivocal diagnosis. Increased leukocytes in the urine may be caused by urinary tract infection, vaginal mycosis, glomerulonephritis, proteinuria, and cystitis.

Each of the above diseases may endanger the health and life of a developing child, so the expectant mother should not ignore the alarming test results and, in the case of an increased amount of leukocytes, visit the gynecologist in charge of the pregnancy. The doctor usually orders a urine culture to make a definitive diagnosis and administer appropriate treatment.

Leukocytes in the urine of pregnancy – symptoms

Increased leukocytes in urine during pregnancy may or may not be accompanied by other symptoms. The symptoms that occur with an increase in urine leukocytes depend on the type of condition that caused the increase.

In the case of vaginal mycosis, a woman also experiences pain and burning when urinating, often the need to urinate, as well as passing it in small amounts. With glomerulonephritis, the woman also struggles with hematuria, arterial hypertension, weakness, lack of appetite and digestive system disorders.

Also read: Fears related to a higher risk of food infection and its complications

Urine leukocytes in pregnancy and inflammation of the urinary system

Urinary tract inflammation, as the name suggests, is an infection that affects the urinary system. This inflammation can involve the bladder, kidneys, ureters, and urethra. Most often, however, it affects the bladder or urethra.

If left untreated, a lower urinary tract infection can develop into an upper urinary tract infection and involve the kidneys. This is called pyelonephritis or a kidney infection. The infection is caused by certain types of bacteria that enter the urinary tract and can start to cause unpleasant symptoms. If left untreated, inflammation of the urinary tract or kidneys in pregnancy can lead to premature birth.

When you try to urinate, you may notice a burning sensation or pain, a feeling that you are unable to empty your bladder completely, the need to urinate frequently, lower abdominal cramps, blood or mucus in the urine, and chills or a fever. You may also notice that your urine has a stronger, more unpleasant odor than usual, or looks cloudy. Some of these symptoms, of course, occur in pregnancy without an infection, so it can be difficult to tell them apart! So how do you determine if it’s just a baby pressing against your bladder, which makes you pee all the time, or is it really an infection?

Diagnosing urinary tract inflammation in pregnancy is quite simple. Your doctor will ask you to do a urine analysis. This test checks, among other things, for the presence of leukocytes in the urine. Leukocytes are another term for white blood cells. White blood cells are not usually found in high numbers in the urine, so they usually indicate an infection. When an infection is present in the urinary tract, white blood cells multiply rapidly and try to attack and destroy the bacteria causing the infection.

Urinalysis can also detect the presence of nitrite in the urine if there is an infection. This is because the bacteria that cause the infection produce an enzyme that converts nitrates into nitrites in the urine. If your initial urinalysis shows leukocytes, nitrites, or blood, your doctor will likely send urine to a laboratory for urine culture. This test confirms the diagnosis of a UTI by determining what specific bacteria are in the urine.

If the urine culture is positive, your doctor will prescribe an antibiotic to fight the bacteria that develops in your urinary tract and causes unpleasant symptoms. It is important that you take the entire course of antibiotics, even if your symptoms improve after a few days. You should also drink plenty of water. This will help flush out the bacteria causing the infection. It is also important to empty your bladder frequently and completely.

See: Protein in urine – causes, symptoms and treatment

Leukocytes in urine during pregnancy – asymptomatic bacteriuria

Asymptomatic bacteriuria (ASB) is a condition in which urine culture reveals significant bacterial growth that is greater than or equal to 105 colony-forming units per milliliter (ml) of midstream clean urine, but with no obvious signs of genitourinary infection. Pregnant women are twice as likely to be affected by the disease as non-pregnant women of the same age. Asymptomatic bacteriuria can be a symptomatic and asymptomatic urinary tract infection.

Early screening and immediate treatment of asymptomatic bacteriuria during pregnancy can prevent further complications of bacteriuria. Asymptomatic bacteriuria is one of the major risk factors for developing a UTI during pregnancy, accounting for approximately 70% of cases.

Bacteria are usually introduced into the urinary tract during sexual intercourse or when wiping after a bowel movement. E. coli is responsible for most cases of asymptomatic bacteriuria.

Other species of bacteria can also cause colonization, including:

1. Klebsiella pneumoniae,
2. wonderful Proteus
3. Pseudomonas aeruginosa,
4. Staphylococcus species,
5. Enterococcus species,
6. Group B streptococci

In non-pregnant women, asymptomatic bacteriuria rarely causes serious problems. However, in pregnant women, the infection can progress, causing acute urethritis, acute cystitis, and acute pyelonephritis.

Asymptomatic bacteriuria can lead to low birth weight and premature delivery. Preterm labor is the most common cause of serious complications – including death – in newborns.

Kidney infection can also lead to acute respiratory distress syndrome (ARDS) or sepsis.

Bacterial infections are usually treated with antibiotics. Non-pregnant individuals with asymptomatic bacteriuria generally do not require treatment. This is because there are no symptoms and the bacteria can clear up on their own over time.

Taking antibiotics can also disturb the normal balance of bacteria in the body. In addition, prescribing antibiotics can promote the formation of antibiotic-resistant bacterial strains.

However, antibiotic therapy for asymptomatic bacteriuria is recommended in the following groups:

1. pregnant women,
2. people who will undergo surgery involving the urinary tract.

People in these groups should be screened for asymptomatic bacteriuria so that treatment can begin as soon as the condition is diagnosed.

Read: The diet a woman follows before conceiving a child affects the child’s health

Leukocytes in the urine of pregnancy – acute pyelonephritis

Acute pyelonephritis in pregnancy complicates up to 2% of all pregnancies and is associated with significant maternal and fetal morbidity and mortality. Premature labor, maternal sepsis, renal failure, and respiratory failure are complications of acute pyelonephritis.

Acute pyelonephritis is one of the most common indications for antenatal hospitalization, estimated at approximately 9,7% of all indications for antenatal hospitalization, and if diagnosed, conventional treatment includes intravenous fluid administration and parenteral administration of antibacterial drugs, and careful monitoring of fluid balance.

Clinical signs and symptoms of acute pyelonephritis include those typical of UTIs including dysuria, frequent urination, urge to urinate, hematuria, and lower abdominal pain. Moreover, the classic symptoms of the upper urinary tract, including pain in the sides or back, may be accompanied by systemic symptoms (e.g. fever, chills, abdominal pain, nausea and vomiting). Clinical signs of fever, bone and spinal angle tenderness (CVAT) with or without leukocytosis are also present.

Urinalysis and urine culture are preliminary tests that should be performed in women with clinical symptoms of UTIs (with acute pyelonephritis being the most severe form of UTI). The urine leukocyte nitrite esterase test strip is often positive, with sensitivity and specificity for a combination of 92% and 95%, respectively.

Read: Remedies for recurrent cystitis

Leukocytes in the urine of pregnancy – other causes

Kidney problems

Kidney dysfunction, seen with inflammation of the kidneys or kidney stones, can also cause elevated levels of leukocytes in the urine. Kidney problems can also lead to the formation of crystals in the urine or sometimes red blood cells.

Both nephritis and kidney stones can also show some characteristic symptoms, such as back pain, difficulty urinating, and a decrease in the amount of urine.

What to do: If you suspect you have kidney stones or nephritis, it’s important to see your doctor or urologist. They will likely order ultrasound and urine tests to identify the cause of the increase in leukocytes and initiate appropriate treatment.

Systemic lupus erythematosus

Systemic lupus erythematosus is an autoimmune disease, which means it is a condition in which immune cells attack the body, causing inflammation of the joints, skin, eyes and kidneys. With this disease, a urine test will often show high levels of leukocytes. This, in combination with a blood test, can help make a diagnosis.

What to do: Lowering the level of leukocytes in the urine is usually done under the supervision of a doctor. Typically, the doctor prescribes medications according to the symptoms presented by the patient, such as anti-inflammatory drugs. In short, by dealing with symptoms related to lupus, it is possible to reduce the level of leukocytes in the urine.

Long-term urinary incontinence

Long-term urinary incontinence may promote the growth and development of microorganisms, causing urinary tract infection and the appearance of leukocytes in the urine. Also, if you hold urine for too long, your bladder will begin to weaken over time and eventually not be able to empty itself completely. This causes urine to accumulate in the bladder, causing the microorganisms to grow.

What to do: If you suspect this may be the cause, it’s important to relieve yourself as soon as you feel the urge to pee. This will prevent a build-up of urine and microorganisms in your bladder. Also, to prevent infection from occurring, it is recommended that you drink at least 2 liters (about 8 cups) of water a day.

Genital infections

Certain genital infections, including bacterial vaginosis, vaginitis, and vaginal candidiasis, are common during pregnancy. They are mainly caused by hormonal changes and can lead to pyuria (which causes leukocytes to form in the urine).

Also read: Vaginitis – bacterial or fungal? Types of intimate infections

Leukocytes in the urine of pregnancy – complications

After the correct diagnosis is made, the doctor will suggest antibiotics to protect the baby and mother. If left untreated, high levels of leukocytes in the urine of pregnancy can cause some complications:

1. the presence of more leukocytes causes eclampsia, which is caused by high blood pressure in a pregnant woman. It is a very serious condition that requires monitoring by the pregnant woman and the attending physician,
2. Cystitis is another complication that causes painful urination. If not treated properly, it can lead to a condition called gangrenous cystitis.
3. kidney stones may develop.

See: Complications of pregnancy are more common in women born prematurely

Leukocytes in urine in pregnancy – treatment

Treatment options may vary depending on the cause and the level of leukocytes in the urine. Some treatments to balance or reduce the level of leukocytes in the urine during pregnancy include:

1. antibiotic therapy – Almost all conditions causing an increase in the number of leukocytes in the urine during pregnancy can be treated with appropriate antibiotics. However, some antibiotics, such as fluoroquinolones, are contraindicated during pregnancy.
2. natural remedies Consuming cranberries, garlic, probiotics, parsley, L-arginine supplements, and getting enough water can help treat UTIs and other urinary tract infections during pregnancy.

Leukocytes in the urine of pregnancy – prevention

Here are some ways you can prevent an elevated level of leukocytes in pregnancy:

1. do regular urine tests as directed by your doctor to prevent recurring infections
2. consume large amounts of water,
3. eat cranberry juice and cranberry supplements
4. maintain good hygiene practices, such as wiping from front to back after defecation
5. avoid synthetic and tight underwear,
6. avoid perfumed gels for washing the genitals.