Why are leukocytes elevated in a smear during pregnancy?

While carrying a baby, a woman has to undergo a large number of tests, which help determine the health status of the expectant mother and learn about the development of the baby. A pregnant woman must carry out an analysis to detect infections developing in the genital tract, because during pregnancy they can occur latently. If it is discovered that leukocytes are elevated in a smear during pregnancy, what does this mean and what measures need to be taken?

…

What is considered normal

Before we figure out what elevated white blood cells in a smear in women mean, let’s decide what amount is considered normal. The norm in women for this component of urine should be up to 15 cells

. If there are a lot of leukocytes in a smear in a pregnant woman, this almost always indicates the development of a certain disease.

Therefore, it is important to promptly examine the external genitalia and undergo an examination.
Examination of vaginal mucus to identify bacteria is considered the most accurate and effective method for determining sexual diseases.

Detection of a large number of blood cells, which are white cells, helps the doctor identify inflammatory diseases, abnormalities in the development of the baby, the negative state of health of the pregnant woman, as well as other diseases that threaten the normal course of pregnancy.

Important! What does leukocytes in urine mean during pregnancy?

When does a woman need to undergo tests to determine the condition of her genital organs? This must be done in the following cases:

• during registration when pregnancy is detected;
• at the 30th week of pregnancy.

If a woman has not previously complained of unusual discharge, discomfort and pain in the genitals, examination of their condition is performed only at the 30th week

. If unpleasant symptoms bother the pregnant woman, this must be done earlier to avoid the development of diseases. If the smear contains elevated components that are hazardous to health, as a rule, such an analysis will be taken more often in pregnant women throughout pregnancy.

Why are leukocytes elevated in a woman’s smear? This usually indicates the development of serious diseases. If the leukocytes in the smear are 25–30 or higher, this indicates pathologies of the reproductive organs that need to be urgently treated before they harm the baby.

When is an examination necessary?

An analysis to identify pathogenic microflora of the vagina and cervix is ​​taken during the examination of a woman who has had unpleasant symptoms localized to the genitals. It is also carried out as a preventive measure.

to prevent the development of diseases dangerous to a woman’s health.

Interesting! Why does white discharge occur during early pregnancy?

Doctors say that the following symptoms and conditions are indications for taking a bacterial test:

• unusual discharge from the vaginal cavity (this means that the patient notices copious, thick, thin or mucous discharge, signaling pathology);
• pain in the lower abdomen;
• long-term use of antibiotics or other medications that were prescribed to the pregnant woman for health reasons;
• discomfort during sexual intercourse;
• registration (first months of pregnancy);
• date of birth (analysis is scheduled 1–2 weeks before the start of possible labor
  ).

If a woman’s norm is greatly exceeded, she will notice the above symptoms, darkening the course of pregnancy.

Important!

If the rate of leukocytes in a smear is increased in women (30, 40), it is taken again, after which the doctor prescribes a complex treatment for the patient that can protect her health and have a positive effect on the condition of the baby.

How is the material for analysis taken and what do its results say?
To do this, the gynecologist uses a special disposable spatula, which carefully takes the contents of the vagina and cervix, usually from their side wall.

Taking such an analysis is quick and completely painless - the procedure only brings discomfort and unpleasant sensations if the vaginal mucosa is damaged by infection or inflammation.

Based on the results of the analysis, it is possible to determine high levels of many components that should be present in small quantities on the mucous membrane of the genital organs.

What does a smear show on flora?

A flora smear is assessed based on the following indicators:

• Epithelium - squamous epithelium - these are the cells of the surface layer of the mucous membrane of the vagina and cervix. The presence of a large amount of squamous epithelium in the smear may indicate an inflammatory process. The absence of epithelium in the smear indicates a hormonal imbalance.
• Leukocytes are blood cells involved in the destruction of pathogenic bacteria. Leukocytes are able to actively penetrate through the wall of blood vessels into the tissues of the body and participate in the fight against infectious agents. Normally, a smear for flora from the vagina contains no more than 10, from the cervical canal no more than 15 leukocytes per field of view, from the urethra - up to 2 leukocytes per field of view. An increase in the content of leukocytes in a smear is a sign of inflammation, and the higher the content of leukocytes in the smear, the more pronounced the inflammatory process.
• blood cells are red blood cells. Normally, a smear for flora may contain single red blood cells (1-2 per field of view). An increase in the number of red blood cells indicates the presence of a chronic inflammatory process, and can also be a sign of injury or hidden bleeding, for example in the presence of cervical ectopia (the so-called erosion, when the vaginal part of the cervix is ​​covered with columnar epithelium that normally lines the inside of the cervix).
• Mucus - normally there is no mucus in the urethra, a moderate amount of mucus is detected in the vagina, and there can be a large amount of mucus in the cervix. An increase in the amount of mucus may be a sign of an inflammatory process, but this criterion does not have much diagnostic value, and doctors rarely rely on it when making a diagnosis.
• Bacteria - normally no flora should be detected in the urethra; rod flora is detected in moderate quantities in the vagina and cervix. Rod flora is most often lactobacilli, which make up 95% of the normal biocenosis of the vagina. Lactobacilli actively colonize the vagina and create an acidic environment in it, thereby preventing the growth and reproduction of pathogenic bacteria. In addition to lactobacilli, other rod bacteria may be present in the vagina, such as Escherichia coli, bacteroides, and various cocci. These are bacteria that, under microscopy, have the shape of balls. This group of bacteria includes streptococci, staphylococci, and enterococci. They are normally present in small quantities in the vagina. If their number increases sharply against the background of the death of normal lactobacilli, this can lead to the development of an inflammatory process. Unfortunately, based on the results of a regular flora smear, it is impossible to determine which specific bacteria and in what quantity are present in the vagina. Therefore, in case of a pronounced inflammatory process, as well as when a large amount of coccal flora is detected in a smear, the doctor prescribes an additional test to make a correct diagnosis - culture of the flora with determination of sensitivity to antibiotics.
• Opportunistic pathogenic flora are microorganisms that live in the human body in small quantities without causing harm, but under certain conditions can lead to an inflammatory process. Such microorganisms found in a flora smear include fungi of the genus Candida and Gardnerella.
• Gardnerella (“key cells”). Gardnerella and other bacteria that live in oxygen-free conditions (so-called anaerobic bacteria) normally live in the vagina in small numbers, without causing symptoms of the inflammatory process. When local immunity decreases, which is quite common during pregnancy, the proportion of these bacteria in the vaginal microflora increases, and a disease occurs - bacterial vaginosis (vaginal dysbiosis). At the same time, “key” cells are found in the flora smear - these are cells of the vaginal mucosa, covered with gardnerella and other anaerobic bacteria. The gardnerellas themselves are not visible in a regular unstained smear. They can only be identified by staining smears with special dyes.
• Mushrooms. Microorganisms of the genus Candida are part of the normal microflora of the mouth, vagina and colon of most healthy people. Normally, the number of these microorganisms is small and they do not cause an inflammatory process. Normally, in some women, a small amount of fungal spores may be detected in the vaginal smear. In the absence of an inflammatory reaction and complaints from the patient, treatment for this condition is not carried out. The detection of a large number of spores or mycelium of a yeast-like fungus of the genus Candida in a flora smear allows one to diagnose candidiasis (or thrush).
• Pathogenic flora. There are microorganisms that under normal conditions should not be present in the vagina of a healthy woman, and the detection of which in a smear on the flora indicates the presence of a serious sexually transmitted disease. Of these infections, trichomonas and gonococci are most often detected in the smear.
• Trichomonas are the simplest microorganisms that have a flagellum and are capable of movement. Detection of trichomonas flora in a smear indicates the presence of a sexually transmitted disease – trichomoniasis. Trichomoniasis in a pregnant woman increases the risk of premature birth, premature rupture of amniotic fluid, and intrauterine growth retardation. In addition, there is a danger of infection of the baby when passing through the birth canal, therefore, if trichomonas are detected in a smear, antibacterial treatment must be carried out during pregnancy.
• Gonococci are bacteria that appear on a smear as double bean-shaped balls adjacent to each other with a concave side. The detection of gonococci in a smear allows the doctor to make a diagnosis of gonorrhea. This is a sexually transmitted disease, which must also be cured during pregnancy. The inflammatory process caused by gonococcus significantly complicates the course of pregnancy, can lead to miscarriage, premature birth, premature rupture of amniotic fluid, infection of the placenta and membranes, and in addition, when the baby passes through the birth canal, the eyes of the newborn are damaged by gonococcus.

Detection of pathogens of other sexually transmitted infections in a flora smear is very difficult. Therefore, if there is an inflammatory process according to the smear, the doctor usually recommends testing for sexually transmitted infections using another, more sensitive method - a PCR smear.

Causes of increased leukocytes

If the norm in women is increased, and the number of cells is 20 or more units, this may be caused by the development of certain diseases, from which the patient is unfortunately not protected during pregnancy. Often in women, the reasons for a leukocyte count in a smear of 30–40 or more are infectious diseases

, which either developed before conception or worsened during pregnancy.

Since a pregnant woman’s immunity at any stage is too weak due to the fact that all its protective properties are aimed at protecting the fetus, the body becomes most vulnerable to various diseases that previously occurred in a latent form.

Increased leukocytes - what is it? If leukocytes are elevated in a smear during pregnancy, this may indicate the development of the following diseases:

• genital herpes;
• mycoplasmosis;
• ureaplasmosis;
• syphilis;
• gonorrhea;
• other diseases that can be transmitted during sexual contact.

If there are a lot of leukocytes in a smear, what does this mean? This phenomenon may also appear due to leaking thrush.

, which often attacks pregnant women due to weakened immunity. In this case, in addition to an increase in this component, a high content of the fungus will be visible in the analyzes.

Also, increased leukocytes in a smear during pregnancy may be due to the development of vaginosis, which occurs as a result of changes in the vaginal microflora. In any case, when identifying components after taking tests, you should not be negligent about your health, because timely treatment and following the doctor’s advice will allow you to restore the normal microflora of the genital organs, as well as protect the baby developing in the womb.

Diagnostics

How to reduce the number of leukocytes on a smear?
To do this, it is necessary to establish the type of disease that caused the increase in the number of blood cells. Knowing the causes of elevated white blood cells in a smear in women, the doctor will be able to prescribe the correct comprehensive treatment

, which will not harm the body of the expectant mother and the fetus.

Having discovered a questionable test result, the gynecologist will once again conduct an examination and take tests. To do this correctly, it is recommended to properly prepare for the procedure:

• complete exclusion of intimacy;
• lack of douching;
• avoiding taking certain types of medications.

If, after taking a repeat test, the results are also unsatisfactory, the patient will be prescribed a comprehensive examination:

• taking contents from the surface of the cervix for bacteriological culture;
• carrying out PCR for the course of latent infections in the body;
• performing an ultrasound scan on the pelvic organs.

Only after this can the disease be treated, which will reduce white blood cells in the vaginal cavity.

Elevated leukocytes in the smear

With inflammatory damage to the organs of the reproductive tract, the number of leukocytes in the smear increases significantly. Moreover, the more white blood cells come into the field of view of the doctor examining the material, the more acute the pathological process.

Most often, an increase in the content of leukocytes in a gynecological smear becomes one of the signs of the following diseases:

• vaginal dysbiosis;
• colpitis (inflammation of the mucous epithelium of the vagina);
• intestinal dysbiosis;
• STD;
• endometritis (inflammation of the lining of the uterus);
• cervicitis (inflammatory lesion of the cervical canal);
• oncological diseases of the reproductive organs;
• adnexitis (inflammatory lesion of the uterine appendages);
• vaginal candidiasis;
• urethritis (inflammatory lesion of the urethra).

To establish the main cause of the development of the inflammatory process, a number of laboratory tests may be required:

• PCR diagnostics;
• bacteriological culture;
• immunological examination of the material.

After identifying all the factors that contributed to the increase in the volume of leukocytes in the smear, the patient is prescribed a comprehensive treatment aimed at eliminating all manifestations of the underlying disease. In most cases, patients are advised to take immunomodulatory, antibacterial or antifungal drugs.

It should be noted that an increase in leukocytes in a gynecological smear does not in all cases indicate the occurrence of an inflammatory process. In some situations, poor test results can signal the presence of problems in the genitourinary system of the woman’s sexual partner. In particular, an increase in the number of white blood cells can be observed in a woman after unprotected sexual intercourse with a man suffering from prostatitis or other diseases of the reproductive system.

How to reduce white blood cells

We found out what an increase in leukocytes in tests is. Now it’s worth understanding how to properly carry out comprehensive treatment that will restore the health of the genital organs.

You cannot treat the disease yourself, as this
can negatively affect the baby’s condition
.

Treatment of the disease directly depends on its nature. Usually, the doctor prescribes antibiotics and special suppositories to patients, which are inserted into the vaginal cavity. These include:

• Terzhinan;
• Polygynax;
• Pimafucin.

Also, treatment of diseases in women, the causes of which are hidden in the development of infection on the genital organs, can be carried out using traditional methods that restore the normal microflora of the vagina

. Folk remedies include:

• Oak bark;
• chamomile decoction;
• red root;
• St. John's wort;
• aloe leaves.

Why doesn’t the amount of hazardous substances in a smear decrease? This can happen if the woman has not taken antibiotics, which inhibit the development of microflora harmful to health. It is known that traditional recipes cannot completely destroy bacteria

, which means that first they need to be destroyed with drugs, and only after that begin to normalize the microflora.

Important!

How to “rinse” the vaginal cavity? To do this, you can use a solution of chlorophyllipt (it is used as a treatment strictly according to the doctor’s indications).

The correct tactics for treating the disease will restore the mother’s health and not harm the baby’s condition. The main thing is not to self-medicate, which poses a direct threat to the lives of both. Useful video: leukocyte level during pregnancy

Microscopic examination of a smear from the vagina and cervix (gynecological smear)

The value of tests

A gynecological smear (smear for flora) is taken from 1 or 2 points: vagina, cervix.
The material is taken with special sterile instruments, applied to a glass slide, and then the smear is analyzed under a microscope. A gynecological smear is taken not on the days of menstruation, before using suppositories, lubricants, or douching. A smear should be taken if there is a suspicion of infectious and inflammatory diseases of the genital tract (discharge, itching, discomfort in the genital area, unpleasant odor) as part of a comprehensive examination, including other types of tests, and examination by an obstetrician-gynecologist.

A gynecological smear is included in the list of tests required during pregnancy and during medical examination. This analysis is also given before procedures involving penetration into the cervical canal and uterine cavity (sonohysterography, insemination, biopsy, etc.).

The smear determines:

• Epithelial cells. The vaginal mucosa is lined with squamous epithelium. Normally, a small number of squamous epithelial cells are found.
• Amount of mucus
• Leukocytes are normally found in small quantities in a smear. With inflammation of the vagina (vaginitis/colpitis), the number of leukocytes in a gynecological smear increases, to the point that leukocytes can cover all fields of vision.
• The flora is normally represented by rods. Coccal, fungal flora and protozoa should not normally be present in the smear. The appearance of such flora indicates trouble - inflammatory, infectious diseases or other disorders of the vaginal microflora, for example, candidiasis (the appearance of fungi), dysbacteriosis (the appearance of so-called “key” cells, the presence of coccobacillary flora), trichomoniasis (if trichomonas are detected). It is impossible to name the microflora when analyzing a smear; to determine the type of specific microorganism, other tests should be used - PCR, bacteriological methods (culture).

Other smears for tests:

1. In some cases, an additional smear is taken from the urethra
2. PCR diagnostics of latent infections
3. Pap smear or oncocytology smear
4. Analysis for papillomavirus
5. Culture of female genital secretions