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Done Blood Test During Pregnancy. Abnormal Leucocyte Count. Prescribed Antibiotic If Fever Happens. Is It Serious?

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Posted on Mon, 24 Sep 2012
Question: Hi,
Good day!
My wife is pregnant (6 months over and 7th has just started / 27th week running). The following is her blood test result and my question is about the Leucocyte count, 15,100 per cu.mm., which is far beyond the normal range of 5000-10,000.
Dr asked whether she is having any fever and recommended to take some antibiotic for 5 days ONLY WHEN she gets fever. But, she doesn't have fever, though she catches cold very often. Kindly let me know if it is so serious and how we can reduce this.

Report:
Erythrocyte count - 3.69 million/c.u. mm. (lesser than the normal range)
Haemoglobin - 10.5 Gms. (lesser than the normal range)

R.B.C. Indices:
P.C.V - 30.9% (lesser than the normal range)
M.C.V - 83.7 femtolitres
M.C.H - 28.5 pico-grams
M.C.H.C - 34%
Leucocyte Count - 15,100 per cu. mm. (more than the normal range)

W.B.C differential count:
Neutrophils - 78% (lesser than the normal range)
Eosinophils - 06%
Basophils - 00%
Lymphocytes - 14% ((lesser than the normal range)
Monocytes - 02%

Peripheral Smear findings:
Abnormalities of Leucocytes - Absent
Abnormalities of Erythrocytes - MILD HYPOCHROMIA
Platelets on Smear - Adequate
Platelet Count - 1,95,000 cu. mm

Antibodies to Hepatitis C Virus - Non Reactive.

In Urine Test, we observed that there are a few Epethelial cells and the 2-3 Pus cells per hpf.

Request you to please let me know your views on this report. To my understanding Leucocyte count will go up only when your body is fighting with some infection. How do we confirm it when she is not having any fever. Is this blood report ok?

Thanks and br, XXXXXXX


doctor
Answered by Dr. Juhi (30 hours later)
Dear XXXXXXX

Leukocyte count is often slightly above normal during pregnacy. But clearly your wife's report shows counts above normal for pregnancy.
Her urine report shows 2-3 pus cells. So get a urine culture and sensitivity done from a good lab.
Urine infection is very common during pregnancy and mostly it is asymptomatic.
According to the culture report take the required abtibiotics. Once urine becomes sterile TLC willl also come down.
If your wife has fever she will feel unwell. Or you can also try record her temperature at different times in a day.
The rest of the blood report is normal. Hb and RBC indices fall a bit below normal during pregnancy and this is normal. Your wife must continue her iron tablets to avoid anaemia.
I hope I have answered your query. If there is anything else please let me know.
Take care,
Dr Juhi.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Juhi (7 days later)
Hi,
As recommended by you, I gave her urine sample for 'Urine Culture and Sensitivity' test and the following is the result.

Grams : Gram stained smear showed few pus cells. Oranisms not seen.
Culture : Urine material was innoculated on Blood agar and MacConkey's agar
plates and incubated at 37C for 48hrs.
Result : Pathogen not isolated.

Is there anything to worry now. I am planning to go for a complete blood and urine test in the mid of September (around 31st week of her pregnancy). Is that timeline ok? or should i rush for any other test now?

Thanks and best regards, XXXXXXX
doctor
Answered by Dr. Juhi (3 days later)
Hi,

With the above report it is evident that there is no reason to worry. The urine routine can show pus cells. The culture and sensitivity is gold standard and as it does not identify any organism it is does not need treatment. Even on staining there is no organism.

The few pus cells on urine microscopy is normal under high power field. This can be explained by poor sample handling or prolonged shelving of the sample before culture.

The high WBC count should be retested after three weeks. It does not take importance in the absence of clinical findings.

Follow these suggestions:
Refrain from sexual activity
Take enough water
Regular walking and varied diet with supplements.
Re do the test after two weeks.

Hope this answers your query.


Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Juhi

OBGYN

Practicing since :2007

Answered : 96 Questions

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Done Blood Test During Pregnancy. Abnormal Leucocyte Count. Prescribed Antibiotic If Fever Happens. Is It Serious?

Dear XXXXXXX

Leukocyte count is often slightly above normal during pregnacy. But clearly your wife's report shows counts above normal for pregnancy.
Her urine report shows 2-3 pus cells. So get a urine culture and sensitivity done from a good lab.
Urine infection is very common during pregnancy and mostly it is asymptomatic.
According to the culture report take the required abtibiotics. Once urine becomes sterile TLC willl also come down.
If your wife has fever she will feel unwell. Or you can also try record her temperature at different times in a day.
The rest of the blood report is normal. Hb and RBC indices fall a bit below normal during pregnancy and this is normal. Your wife must continue her iron tablets to avoid anaemia.
I hope I have answered your query. If there is anything else please let me know.
Take care,
Dr Juhi.