Q: I am 16 weeks pregnant and my WBC count has increased from 7500 to 10,500 within two months. Is it normal in pregnancy? I suffered from dehydration for 8-10 weeks due to morning sickness and vomiting. I got a blood test done in my 14th week. My CBC count does not show any monocytes. Is this normal? My urine report is all fine, but it shows the presence of bacteria. However, the type or quantity is not mentioned. Does this mean I have urinary tract infection?

A:Pregnancy leads to many functional (physiological) and structural (anatomical) changes in the body. They occur due to the (a) needs of the developing baby, placenta and the uterus and (b) increasing levels of pregnancy hormones especially progesterone and oestrogen. Physiological leukocytosis (increase in white blood cells) refers to a total leukocyte count above the normal, without the association of any known disease process. It is documented that the number of leukocytes in peripheral blood increases considerably during pregnancy. The WBC count may increase up to 15,000/µl (or even higher during labour and following delivery). The total mass of WBCs also increases to fill the increased blood volume. The reason for the increase in WBCs is unknown, but is probably a hormonal response. In case you have no fever, sore throat, urinary problem or other symptoms suggestive of an infection, these counts are normal. In a differential blood count the percentage of monocytes can vary from 0 to 12. The presence of bacteria in a urine specimen, in the absence of any symptoms, pus cells or proteinuria, is of no clinical significance.