Erythrocytes in the urine during pregnancy: norms and reasons for the increase in the rate. Erythrocytes in the urine during pregnancy

Most often during pregnancy, a urine test is taken. It is inexpensive, simple and informative. This study can tell a lot about the health of the expectant mother.

To obtain a reliable result, the analysis must be done correctly and quickly delivered to the laboratory. Ideally, the time between the time the urine was collected and brought to the study should not exceed an hour. If necessary, store it in a cool place, and indicate the time of collection on a sterile jar. It is better to buy a container at a pharmacy.

In laboratories, urinalysis is taken, as a rule, from 8 to 10 hours. The average portion of morning urine should be collected. Before this, thoroughly wash the genitals and close the entrance to the vagina with a cotton swab to avoid getting discharge from there.

The expectant mother needs to know about pregnant women in order to understand the result herself. The study determines the following:

quantity delivered;

color;

transparency;

reaction;

specific gravity.

And also the quantity

Sahara;

leukocytes;

bacteria;

erythrocytes;

squirrel;

cylinders;

salts;

epithelium;

mucus.

Each indicator individually and their combination can signal a specific problem in the body. By the way, the norms of analysis for pregnant women and ordinary women are practically the same.

So, during pregnancy should not exceed 4 in the field of view. However, their increased value in the absence of symptoms may be temporary.

It is believed that the uterus during childbearing contributes to a slight violation of the blood flow in the bladder. This leads to the fact that erythrocytes in the urine of pregnant women are periodically detected.

However, to exclude formidable kidney diseases, it is better to do their ultrasound. In addition, it is advisable to pass urine several times according to Nechiporenko. Because inflammation of the kidneys is a disease that can lead to miscarriage and threaten the life of the mother.

It is also important which red blood cells are found in the urine during pregnancy. If they are changed, and even in combination with cylinders, then this is a reason to contact a nephrologist.

Also, red blood cells in the urine during pregnancy can be detected in gynecological diseases. If they are in the urine without protein and cylinders, then this indicates that the source of bleeding is not the kidneys.

A large number of red blood cells in the urine can be determined without analysis. She becomes reddish. However, this is only if the diet does not include beets, which tend to stain urine.

In addition to kidney problems, hematuria can accompany diseases of other parts of the urinary system (cystitis, urolithiasis, infection, tumors, urethritis). The cause of its appearance may be taking certain medications and food poisoning. Red blood cells are also determined in heart failure, infectious mononucleosis, intestinal tumors, hemorrhagic fever, smallpox, malaria, problems with blood clotting.

What are the standards for other indicators? Bacteria, cylinders, salts, mucus, protein, sugar ideally should not be. Leukocytes can contain up to 5 in a - a small amount. The transparency of the urine should be complete, the color is yellow. The normal reaction can be neutral, slightly acidic or slightly alkaline. should be in the range of 1020-1026. It is enough to bring 100 ml to the laboratory for analysis.

Thus, red blood cells in the urine during pregnancy may be the norm. However, it is better to conduct additional research and make sure that there are no serious diseases that can adversely affect pregnancy. The decision is made by the doctor, taking into account the values of other indicators of analyzes and the patient's well-being.

In pregnant women, in medicine it is called hematuria and is not the norm. This may be a sign of a serious illness or a consequence of physiological changes temporarily present in the female body.

To establish the causes of blood getting into the tests, additional examination methods are prescribed in the form of ultrasound and consultations of narrow specialists. If the condition is accompanied by clinical manifestations of inflammation, or the urine has a pronounced red color, the woman is hospitalized and bed rest is prescribed until the diagnosis is clarified.

The role of red blood cells and their norms

The human hematopoietic system consists of shaped cellular elements. Some carry out a protective function, others provide clotting, and red blood cells are responsible for the gas exchange of the body with the environment. These red cells contain hemoglobin, necessary for human life. Especially the function of the cells is important during the gestation of the fetus for its full supply of oxygen.

If elevated during pregnancy is detected, this is more often a sign of pathology. For ordinary female patients, the presence of red bodies in urine up to 2-3 per field of view is allowed. The discovery of the same number of cells in pregnant women is already alarming the doctor. During this period, the body is unstable to infections and relapses of chronic diseases that negatively affect the expectant mother and baby.

Blood in the composition of the urine can be present both in small quantities when it is detected during the study for a general analysis, and in large quantities when it is visible to the naked eye. If the pathology is detected by chance and the number of red blood cells does not exceed 50, microhematuria is diagnosed. It does not change the color of urine and is detected during a routine test. When calculating a larger number of red bodies, they speak of gross hematuria.

Attention! Eating bright red vegetables, fruits and drinks, as well as certain drugs, leads to false hematuria, which is not dangerous to the health of the pregnant woman and is not characterized by an increase in red blood cells.

What conditions and diseases cause blood in the urine

During gestation, a woman's organs are subjected to increased pressure. This causes microtrauma and bleeding of the tissues of the excretory system. In the later stages, erythrocytes in the urine may be increased due to physiological changes in the hormonal background.

These conditions do not threaten the health of the future mother and child and do not require specific treatment. Much more dangerous is hematuria caused by pathologies of the urinary system of an infectious and inflammatory nature.

cystitis and urethritis

These diseases develop due to compression of the ureters by a growing fetus and the accumulation of specific bacteria in stagnant places. Inflammation in the walls of the urethra and bladder causes friability of the membranes and contributes to their bleeding. Pathologies are accompanied by the following symptoms:

burning sensation in the urethra;
pain and pain when urinating;
discomfort in the lower abdomen;
increased urge to empty the bladder, including false ones.

In rare cases, subfebrile fever and deterioration in general well-being join. During this period, a short-term increase in the number of red blood cells is found in the urine of a pregnant woman. Treatment is carried out by a urologist under the supervision of a gynecologist. Assign antibacterial drugs allowed in the current trimester, restorative therapy and vitamins.

Urolithiasis disease

One of the reasons for the appearance of massive red blood cells in the urine during pregnancy is the formation of kidney stones. Their accumulation occurs imperceptibly, but when moving into the ureters, renal colic develops, which is accompanied by acute symptoms.

The pain is so strong that women may confuse the condition with premature birth. In this case, the diagnosis is made on the basis of ultrasound. Sometimes the ureters are injured by small particles of stones (sand) that move along the urethra with moderate pain.

Pyelonephritis

Inflammation of the kidneys and renal pelvis often causes red blood cells to enter the urine during pregnancy, especially in the last trimester. During this period, the growing uterus compresses the internal organs. This prevents the normal flow of urine from the kidneys. As a result, pathogenic bacteria accumulate in the pelvis, which spread to the lower urinary tract.

Primary pyelonephritis is rarely diagnosed. More often during the bearing of the fetus, the chronic form, which had previously been hidden, aggravates. Inflammation develops against the background of weakened immunity and hormonal changes.

Symptoms appear:

high body temperature;
chills;
unilateral or bilateral lower back pain;
pouring sweat;
dry mouth;
an increase in blood pressure.

In the study of general blood tests, an increase in the number of leukocytes and ESR is detected. In the urine of a pregnant woman, hematuria is detected.

The condition is dangerous for the health of the expectant mother and the development of the fetus. With any severity of the course of pyelonephritis, immediate therapy is required. In special cases, if the disease is accompanied by the development of renal failure and hypertension, in late pregnancy, they resort to artificial delivery.

Important! If a woman with hematuria has signs of renal inflammation, treatment is carried out strictly in a hospital.

Malignant neoplasms

Often, oncological diseases of the urinary organs are hidden, and blood in the urine may be the only sign indicating the presence of a tumor. Timely diagnosis helps not only to get rid of the disease, but also to maintain the current pregnancy. The level of medicine today allows you to treat malignant tumors without harm to the fetus.

Diabetes

Often, blood in the urine is detected in women with diabetes. This is due to the heavy load on the glomeruli, which are constantly filtering sugar crystals. With a long course, the disease causes increased vascular permeability and can cause kidney failure.

Diabetics are under special control and are tested more often than healthy women. Doctors advise planning a pregnancy at least 4-6 months in advance.

Attention! Hematuria with a simultaneous increase in glucose in the urine is a threatening symptom for the course of pregnancy and may be a sign of a complication or debut of diabetes mellitus.

Other causes of erythrocyturia

The ingress of red blood cells into the urine during pregnancy is not normally provided. But it happens that droplets of blood are entered into analyzes from other foci. This is facilitated by improper collection of urine. It is impossible to determine where the red bodies come from according to the results of the study. In this case, the collection of anamnesis and examination of the woman helps.

Common sources include:

hemorrhoids and fissures of the rectum;
scratching in the anus and in the intimate area (with helminthiases and thrush);
vaginal bleeding with a threat of miscarriage;
colpitis;
cervical erosion.

If these diseases are suspected, for accurate diagnosis, pregnant women are prescribed a fecal examination for enterobiasis, a smear for the microflora from the vagina, and a consultation with a proctologist.

At the same time, a repeated general analysis is carried out. In the hospital, urine is taken using a catheter. This prevents the ingress of blood from other foci.

On a note! Often, red blood cells in the urine during pregnancy are increased due to the influence of heat, stress, or overwork. The condition is transient and does not threaten health.

What tests can be ordered?

24 hours before passing urine, pregnant women should be excluded from the diet of coloring foods, do not take vitamins. Tablets are drunk only if it is necessary and after consulting a gynecologist.

In the morning before the procedure, a hygienic washing of the perineal area without soap and gels should be carried out. You need to collect the analysis in a clean jar or special pharmacy utensils. The vagina should be closed with a swab, the anus is also covered in the presence of cracks in the rectum.

General analysis and additional research according to Nechiporenko. A sterile container is not required, it is enough to rinse the dishes with soda. Begin urination and finish it in the toilet. Only the average portion is collected in the container. An increase in the content of red blood cells during pregnancy is the reason for the appointment of a study according to Nichiporenko. It is carried out with the aim of separately counting red cells per 1 mm of urine sediment in a cube.
. This analysis is prescribed for true hematuria to diagnose kidney damage in pregnant women. Urine must be collected every three hours in a separate bowl. In total, 8 labeled containers must be handed over to the laboratory. When researching according to Zimnitsky, all urine is collected per day. If it does not fit in a certain container, take an additional one and indicate the time on it.
bacteriological analysis. It is prescribed to confirm the infectious process in the urinary system and to identify the pathogen. The material is collected strictly in sterile dishes. An average portion of morning urine is taken. The container is tightly closed and sent to the bacteriological laboratory.
Three glass test. Erythrocyte formulas in different portions of urine help to determine where the focus of bleeding is located. It's either the urethra, or the kidneys, or the bladder. You need to collect the analysis in three different containers at a time. Based on the results, the doctor prescribes treatment for the affected area.

What is the danger of an increase in red blood cells in urine tests and what to do

By itself, hematuria does not harm the health of the pregnant woman and the unborn baby. But the condition is a symptom of various diseases that cause serious complications. So, blood in the urine may appear due to rare pathologies:

thrombocytopenia;
violations of the mechanism of blood clotting;
hereditary disease of blood vessels and connective tissue;
injuries of internal organs.

Therefore, you need to immediately undergo an examination that will identify the cause and make it possible to start treatment in a timely manner.

During the period of bearing a child, any independent actions to eliminate hematuria are strictly prohibited. Therapy is carried out under the supervision of specialists who prescribe the treatment of concomitant diseases with approved drugs.

According to statistics, in most women, red blood cells in the urine appear in small quantities, are not a sign of serious illness and do not threaten the course of pregnancy. If hematuria has developed not against the background of pathology, but due to external factors or fatigue, it is enough to take a break from physical labor and calm down to normalize the tests. Doctors recommend taking valerian, drinking mint tea and walking more.

Preventive actions

Pregnancy planning is an important step in prevention. During the preparation period, it is necessary to fully examine, treat chronic diseases and sanitize foci of infection.

In the process of bearing a child, it is possible to avoid getting red blood cells into the urine if you follow the schedule for visiting the antenatal clinic. It is necessary to maintain a hygienic regime, pay attention to any changes in the body and avoid hypothermia. Urine tests should be taken according to the schedule after preliminary preparation in compliance with all the rules. This will help avoid unnecessary worries about false hematuria.

It is categorically impossible to consider the presence of red blood cells in the urine during pregnancy as the norm until a complete and objective examination is carried out. But there is no need to emotionally react to changed analyzes until the true causes are identified. It must be remembered that nervous tension and stress cause irreparable harm to the health of the mother and fetus.

When observing pregnancy, the attending physician prescribes a urine test before each visit. Such frequent research may seem redundant only at first glance. The body of a woman undergoes strong changes, and the organs are under serious stress, and any failure must be noticed in time. So, if red blood cells in the urine are increased during pregnancy, this is a natural and short-lived phenomenon, and may indicate a rather dangerous pathology.

Erythrocytes are elements of the blood that contain hemoglobin. Normal blood flow carries trillions of red cells, and a decrease in their number causes unpleasant consequences. But in the composition of urine such inclusions should not be.

Normally, urinalysis does not detect red blood cells. It is acceptable to have 1-2 red bodies in the field of view. If there are many more of them, this condition is called hematuria or erythrocyturia, which literally means blood in the urine. At the same time, they distinguish:

microhematuria, when there are from 5 to 50 erythrocytes;
gross hematuria, if there are much more blood cells.

Microhematuria and the initial stages of macrohematuria can only be detected by laboratory methods. Visually, urine retains its natural color. One drop of blood in the urine can turn urine pink, and a large number of red blood cells red and even burgundy brown. The extreme degree of macrohematuria is characterized by urine in the form of "meat slops".

Note!Changing the color of urine does not always mean pathology. Urine becomes red in such situations: when eating bright vegetables and berries; a large number of food dyes coming with food, drinks; from taking vitamins and certain medications.

False hematuria refers to any cases of mixing of blood with urine, not associated with disorders in the kidneys, ureters and bladder. Moreover, the red color is associated not only with red blood cells. There are several other diseases with similar manifestations, but completely different causes: hemoglobinuria and myoglobinuria. Therefore, without a laboratory test, it is impossible to confirm or refute the diagnosis.

Causes of red blood cells in the urine

During pregnancy, the growing fetus puts pressure on the organs surrounding the uterus. The kidneys and urinary system are forced to work intensively under increased stress. Therefore, erythrocyturia in 2 out of 3 cases is caused by small hemorrhages that do not require treatment, without posing a threat to the health of the pregnant woman and the unborn baby.

Changes in the hormonal background can also provoke an increased content of red blood cells in the urine. Such types of hematuria are called primary, pass quickly, are more often recorded at long gestational ages. Other reasons for mixing red blood cells with urine are not so harmless. The most frequent of them:

Infections of the genitourinary system. Occur as a result of infection from the outside, or due to squeezing of the bladder and stagnation of fluid.
Cystitis, urethritis. With inflammation of the bladder and urethra, the walls of blood vessels become thinner and may bleed.
Stones in the kidney or bladder mechanically damage tissue as they travel through the urinary tract, causing minor bleeding. Differs in a sharp pain syndrome and short duration.
Pyelonephritis. Infectious kidney disease, which worsens during pregnancy, contributes to the passage of altered erythrocytes through the affected renal glomeruli.

A condition when red blood cells in the urine are significantly increased during pregnancy can warn of severe kidney pathologies: nephritis, glomerulonephritis, heart attack or kidney cancer. Malignant tumors of other pelvic organs are also often accompanied by hematuria, such a serious symptom should not be ignored.

It's important to know!It is necessary to find out the cause of hematuria of any degree, to exclude dangerous pathologies of the kidneys. During pregnancy, kidney failure can develop rapidly. This is a serious threat to the life of a woman, the fetus and often leads to premature birth.

Of particular importance in the diagnosis of the causes of hematuria is the appearance of red blood cells that enter the urine. Unaltered cells indicate latent bleeding, and “leached”, hemoglobin-free blood cells indicate kidney damage (glomerulonephritis, pyelonephritis), as a result of which red blood cells penetrate the impaired renal filter.

Altered and whole erythrocytes are clearly distinguishable when examined under a microscope, and their number indicates the severity of the disease.

Kidney pathologies often manifest themselves as the presence of protein and red blood cells in the urine, and regular tests can detect such dangerous changes in the early stages. To obtain reliable results, and hence the accuracy of diagnosis, urine should be collected correctly.

Rules for collecting urine for pregnant women

Preparation for a general urinalysis begins the day before. Salty, spicy dishes, beets, bright berries should be excluded from the diet. In agreement with the attending physician, stop taking medications that can cause bleeding or change the color of urine. Vitamin complexes are also temporarily canceled. For the same period limit physical activity and sexual intercourse.

Eliminates the erroneous detection of leukocytes, protein or erythrocytes in a routine urinalysis, following a few simple rules:

Urine should be taken only after hygiene procedures - thorough washing without antimicrobial agents.
It is better to use a pharmacy sterile container with a tight lid to collect urine.
Only an average portion of urine should be collected for research. Beginning and ending urination should be past the container.
It is advisable not to touch the edges of the container to the body - to make a fence on weight. This reduces the likelihood of accidental entry of erythrocytes, protein, and other impurities from the external genital organs into the sample.

The container for analysis is immediately tightly closed and delivered to the laboratory for an hour, a maximum of two.

If the results show blood in the urine, another study according to Nichiporenko is prescribed. The rules for passing the analysis are the same, and the quantitative calculation of erythrocytes is performed per milliliter of material, which gives a more accurate result.

To determine the causes of hematuria, in addition to the study according to Nichiporenko, a separate analysis of three portions of urine (three-cup sample) is carried out. The number of red blood cells in each sample will tell specialists the place where the pathology is concentrated.

How to treat elevated red blood cells in the urine?

Erythrocyturia in itself is not a disease, it is only a symptom of damage to the genitourinary system or kidneys, diabetes in pregnant women, autoimmune disorders, and many other diseases. In total, there are more than 100 causes of pathology. When the disease that causes the appearance of red blood cells in the urine is cured, the symptom also disappears.

Attention! Attempts to independently cope with the signs of erythrocyturia, stop or reduce bleeding with home methods, can distort the clinical picture and make it difficult to make a diagnosis.

Treatment depends entirely on the identified causes of the disorder. If the appearance of red blood cells was provoked by physical fatigue, heat, cold, or a slight injury to the internal organs, then rest with supportive therapy is enough for recovery.

More serious cases require special treatment. With gross hematuria, as well as when protein and red blood cells are detected simultaneously, examination and treatment are recommended to be carried out in a hospital. Thus, possible complications for the woman and the fetus are minimized.

To establish an accurate diagnosis at any stage of hematuria, a comprehensive examination is carried out. Additionally assigned:

Ultrasound of the abdominal and pelvic organs;
repeated urinalysis according to Nichiporenko or a three-glass test for red blood cells;
colposcopy - gynecological examination using a special microscope;
swabs from the urethra, vagina, cervix to detect infections, including sexually transmitted infections (chlamydia, gonorrhea, herpes, and others).

Cystoscopy or x-rays with the use of contrast agents during pregnancy are carried out in extreme cases, when the expected harm from the procedure is less than the danger of the disease itself. If possible, replace such hardware examinations with computed tomography.

Rapid identification of the causes of hematuria allows you to choose the most benign treatment option. With gross hematuria, one of the urgent tasks is to stop blood loss. But they try not to use drugs to increase blood coagulation until the diagnosis is fully established. During pregnancy, the use of drugs and diagnostic procedures is limited, therefore it is extremely important to detect the problem in time.

Even if the erythrocytes in the urine during pregnancy are slightly increased, the violation is quickly corrected or disappears on its own, this situation cannot be called the norm. After childbirth, a woman should be attentive to any alarm signals from the kidneys, conduct an examination of the genitourinary system, do not neglect medical examinations, monitor nutrition and regulate physical activity.

A pregnant woman should remember that her psychological state greatly affects the entire process of bearing and the health of the unborn baby. Stress or increased anxiety about less than ideal test results can exacerbate even minor disorders. The best help to the body in this crucial period is emotional balance and careful observance of medical prescriptions.

It is not uncommon for a laboratory test to detect red blood cells in the urine during pregnancy. Normally, in women, the content of red blood cells is contained up to 3 in the field of view. Exceeding this indicator indicates pathology. The most common cause is diseases of the genitourinary organs.

Elevated red blood cells in the urine in most cases are a sign of pathology of the kidneys or bladder. Urine is formed as a result of filtration of blood plasma. Erythrocytes can enter the urine at different stages of uropoiesis. There are 2 main mechanisms for the development of this pathology: a violation of the filtration function of the kidneys (damage to the glomeruli) and damage to blood vessels.

An excess of red blood cells in the urine is called hematuria. There are microhematuria and macrohematuria. In the first case, red blood cells are detected only during microscopy. The appearance of urine is not changed. In the second case, an admixture of blood is detected with the naked eye. Sometimes urine resembles meat slops.

This can occur with severe renal failure and urolithiasis. Erythrocytes in urine are altered (alkaline) and not altered (fresh). This is very important for making a diagnosis. The appearance of alkaline erythrocytes without hemoglobin may indicate the development of glomerulonephritis. Red blood cells in the urine during pregnancy appear with the following pathology:

acute and chronic glomerulonephritis;
urolithiasis;
hydronephrosis;
acute cystitis;
tumors of the kidneys and bladder;
kidney cancer;
bladder cancer;
hemophilia;
uterine bleeding;
the threat of miscarriage;
malaria;
severe intoxication;
lack of folic acid, thiamine, pyridoxine, cyanocobalamin in the body;
blood clotting disorder;
infectious mononucleosis;
heart failure.

The appearance of red blood cells in the urine of pregnant women is possible while taking certain medications (sulfonamides, anticoagulants).

Urolithiasis disease

Many women develop urolithiasis while carrying a baby. Its prevalence among pregnant women is 0.2-0.8%. In most cases, the disease develops even before the conception of a child, but women are unaware of this. During pregnancy, every third woman has a worsening condition.

At the beginning and at the very end of the term, the most common is the movement of stones along the urinary tract. The situation is aggravated by the presence of pyelonephritis. Most often, this pathology is diagnosed in women aged 25 to 50 years. Stones can be located in the kidneys, ureters and bladder. The following risk factors for the development of urolithiasis in pregnant women and the appearance of hematuria are distinguished:

violation of mineral metabolism;
monotonous food;
hypodynamia;
improper drinking regimen;
anomalies in the development of the urinary tract;
infectious diseases.

Urolithiasis in pregnant women is manifested by the following symptoms:

renal colic;
nausea;
the appearance of blood in the urine;
expulsion of the stone.

When the ureter is blocked or the bladder is injured, pain occurs during urination. Such women often empty their bladder. The most common is microhematuria. It is caused by damage to the veins. In severe cases, the urine becomes reddish in color. The appearance of blood is observed after renal colic.

In 30% of cases, the disease in pregnant women occurs in an atypical form. In this situation, there are signs of an "acute abdomen". Sometimes urolithiasis is complicated by pyelonephritis. In this case, there is a risk of developing toxicosis. In the absence of complications, the risk to the mother and fetus is minimal. Sometimes there are spontaneous abortions.

Cause of malignant tumors

If the laboratory test does not reveal a norm, then tumors may be the cause. Hematuria is a sign of kidney and bladder cancer. These malignant diseases are quite rare. The development of cancer, in most cases, begins long before pregnancy and childbirth. The following factors contribute to this:

burdened heredity;
smoking;
exposure to carcinogens;
chronic diseases;
chronic renal failure.

Blood in the urine with bladder cancer appears during the germination of the organ. She is bright scarlet. Its volume is small (a few drops). In advanced cases, there is massive bleeding. Other symptoms of the disease include pain when urinating, discomfort in the pubic region, false urge to go to the toilet. Kidney cancer in the early stages is asymptomatic.

Hematuria is the main (pathognomonic) symptom of the disease, appears against the background of complete well-being. There is no pain involved. An excess of red blood cells in pregnant women with kidney cancer is an early sign. Gross hematuria is the result of damage to blood vessels and tumor growth of surrounding tissues. In advanced cases, blood clots are found in the urine.

Glomerulonephritis during pregnancy

If the rate of red blood cells in the urine is exceeded, then glomerulonephritis may be the cause.

This pathology is detected in 0.1-0.2% of pregnant women. There are acute and chronic glomerulonephritis. This pathology of the kidneys is characterized by damage to the nephrons and glomeruli, which leads to impaired filtration function. There are the following reasons for the development of glomerulonephritis in pregnant women:

stagnation of urine on the background of a bacterial infection;
autoimmune disorders;
transferring angina, scarlet fever, erysipelas, influenza;
hypothermia;
decrease in immunity.

Acute glomerulonephritis is manifested by swelling of the extremities and face, increased pressure and body temperature, pain in the lumbar region, nausea, vomiting, hematuria, decreased diuresis and the appearance of protein in the urine. Perhaps the development of eclampsia (toxicosis with the development of convulsive syndrome). Hematuria is most pronounced on the first day of the disease.

An increase in erythrocytes in the urine is an integral part of the urinary syndrome in pregnant women. Hematuria is combined with an increase in the density of urine, the appearance of hyaline and granular cylinders in it, and an increase in protein. With microhematuria, the number of red blood cells in the field of view varies from 4-5 to 100. In severe cases, urine becomes the color of meat slops. This indicates the development of acute renal failure.

Chronic glomerulonephritis with nephrotic syndrome rarely affects the course of pregnancy. Exacerbations are most often observed after childbirth. The least dangerous is the latent form of the disease. Acute glomerulonephritis can cause the death of a baby in the womb and the birth of premature babies. There is also a risk for the woman herself.

Therapeutic tactics for hematuria

Before treatment, it is necessary to conduct a thorough diagnosis and establish the cause of hematuria. The following studies are being carried out:

analysis according to Nechiporenko;
three glass test;
Ultrasound of the kidneys, bladder and ureters;
excretory urography;
blood analysis.

If there is uterine bleeding, then a smear is taken. Be sure to assess the condition of the fetus and uterus. If urolithiasis is suspected, X-ray examination and cystoscopy should not be performed. When urolithiasis is detected, treatment involves herbal medicine, drinking plenty of water, following a strict diet, using Canephron or Cyston.

With hematuria against the background of renal colic, analgesics are not used. You can not carry out thermal procedures. Depending on the type of stones, various mineral waters are used. The operation is recommended after childbirth. If glomerulonephritis is detected, pregnant women should be under the close supervision of a doctor. Many drugs are contraindicated for pregnant women.

The least dangerous drugs are used. Antihypertensives, vitamin E, diet No. 7 are shown. Women should limit their intake of fluid, salt and protein foods. In severe cases, the doctor may raise the question of terminating the pregnancy. With uterine bleeding, it may be necessary to use hemostatics (Vikasol, Dicinon), applying cold to the stomach, and using hormones. Thus, repeated hematuria is a reason for a comprehensive examination.

The detection of a large number of red blood cells in the urine of a pregnant woman is a sign of a serious pathology. It is urgent to undergo a diagnosis and start treatment.

Erythrocytes in the urine during pregnancy should not be detected. If they appear, this indicates an inflammatory disease of the kidneys or downstream organs. Blood during urination can be detected against the background of an infectious process that is not associated with the excretory system.

Types of hematuria

Erythrocytes in the urine of pregnant women can appear without pathology. The lifetime of these cells is 100-120 days. “Spent” erythrocytes are excreted with feces, but a single blood cell enters the urine.

An analysis is considered normal, in which 1-3 erythrocytes are in the field of view. A woman's physiological norm is higher than that of a man.

Not necessarily red blood cells in the urine are visible to the naked eye. Sometimes the outwardly biological fluid is not changed, the cells are found only under a microscope - this is microhematuria.

Erythrocytes can enter the urine formed, biconcave, with hemoglobin. The second option is alkaline bodies, altered red blood cells. They are colorless, ring-like, do not have hemoglobin.

If hematuria during pregnancy is visible to the naked eye, then the urine takes on a color from pink to brown. The color is determined by the concentration of cells penetrating the vascular wall: the more of them, the redder the urine. Gross hematuria is a serious reason to see a doctor, since the loss of red blood cells threatens to malnutrition of the fetus and complications for the woman herself.

Reasons for violation

Elevated red blood cells in the urine of pregnant women are found in various conditions. Factors of cell loss can be renal, somatic, postrenal.

If a urine test reveals altered red blood cells, this is a sign of kidney disease or somatic pathology. Until the cells reach the urethra, they are partially destroyed, lose hemoglobin and become discolored. If the red blood cells found in the urine retain their color and shape, then the reason for their loss is below the kidneys: in the bladder or urethra.

The causes of hematuria are not only diseases. The appearance of red blood cells in the urine is affected by stress, vitamin deficiency (folic acid, group B), overwork, physical activity, and a passive lifestyle. Problems can begin due to an excess of spices in food, drinking alcohol.

Renal and Postrenal Factors of RBC Loss

Erythrocytes in urine tests are elevated with renal problems:

urolithiasis disease;
injuries of the kidneys and blood vessels;
inflammatory diseases;
oncological processes of the kidneys;

Stones can be localized in the kidney, ureter, bladder or urethra. They move and, moving along the channel, scratch its walls. Due to such damage, as well as injury or injury, there is a violation of the integrity or rupture of the urinary organs. If the bleeding is massive, the person quickly loses consciousness.

Pyelonephritis increases the permeability of the vascular walls, so even large cells enter the urine. The consequence is a violation of the filtration zone of the kidneys, against which the urine contains atypical components, in particular, erythrocytes.

If a tumor develops, it grows, puts pressure on the parenchyma of the organ, and penetrates into the vessels. In this case, bleeding may occur, and the blood will come out with urine.

Hydronephrosis is swelling of the kidney that makes it difficult for urine to pass. The organ is stretched, vascular microdamage and hematuria occur.

The causes of postrenal pathology are the same as those of the kidney. Erythrocytes are increased in the urine with inflammation and trauma of the bladder, the appearance of stones, or if a tumor develops.

Somatic causes

Elevated red blood cells in the urine during pregnancy may appear due to the physiological pressure of the growing uterus on the excretory organs. An increase in the concentration of red blood cells occurs at a later date, after 26 weeks.

Blood in the urine during pregnancy appears if its source is in adjacent organs. Bloody discharge from the uterus is a sign of a threatened loss of a child, so it is necessary to investigate the cause of the violation as soon as possible so as not to miss placental abruption, premature birth or late miscarriage.

Erythrocytes are found against the background of pathologies of the reproductive system: cervical erosion, colpitis.

Erythrocytes are detected in urine with a decrease in blood clotting and with increased permeability of the vascular wall. In the first case, hematuria is provoked by thrombocytopenia (a decrease in the concentration of platelets) and hemophilia. It occurs due to a deficiency of blood clotting factors.

The permeability of the vascular wall changes due to inflammation, intoxication caused by viruses and bacteria. Altered red blood cells are increased in venereal diseases, hormonal abnormalities, severe endocrine disorders (diabetes mellitus), and heart failure. It can be infectious diseases: mononucleosis, malaria.

Diagnostics

To determine the cause of the appearance of red blood cells during urination, a woman must undergo a comprehensive examination:

analyses;
gynecological examination;
instrumental diagnostics.

To assess the functioning of the urinary system, a general and biochemical blood test is prescribed. They allow you to identify signs of inflammation. A urinalysis shows whether there are bacteria, mucus, or white blood cells in it. allows you to count the shaped elements.

Examination of a pregnant gynecologist makes it possible to detect erosion, signs of inflammation of the vagina, cervix and body of the uterus. The disease can be confirmed by colposcopy. The doctor takes a smear on the flora from the urethra and cervix.

Violation of the functions of the excretory system can be determined by ultrasound. Method, shows the expansion of blood vessels, cavities, defects of the mucous membrane. At the same time, it is not at all dangerous for a pregnant woman and a baby, and you should not be afraid of him.