Noticed “leukocytes” flagged in your urine report and felt your mind race? That reaction is understandable. In many Indian labs, urine tests are part of routine ANC, and one line on the report can look alarming without context. Leukocyturia during pregnancy simply means white blood cells are present in urine. Sometimes it points to a urinary tract infection. Sometimes it is just a contaminated sample (very common when vaginal discharge is heavier in pregnancy). And sometimes it reflects irritation or inflammation without bacteria.
The safest mindset is practical: confirm the result with a well-collected sample, look for symptoms, and use a urine culture to decide on treatment—because antibiotics in pregnancy should be targeted, not guessed.
What leukocyturia means during pregnancy
A simple definition: white blood cells in urine
Leukocyturia during pregnancy means white blood cells (leukocytes) are detected in urine. White blood cells are immune cells, they appear when the body is responding to inflammation somewhere along the urinary tract (urethra, bladder, ureters, kidneys).
Often, leukocyturia suggests a urinary infection. But it is not automatic. It can also happen due to:
- local irritation (for example, mechanical pressure from pregnancy, a urinary stone)
- inflammation around the vulva/vagina
- contamination of the urine sample by vaginal secretions
In many laboratories, leukocyturia becomes “significant” around ≥ 10⁴ leukocytes/mL (thresholds vary by method). Some reports use microscopy and list WBC/HPF (white blood cells per high-power field).
“Septic,” “aseptic,” or “isolated” leukocyturia: what labs usually mean
These terms describe whether bacteria are seen along with leukocytes:
- Septic leukocyturia: leukocytes plus bacteriuria confirmed on urine culture—strongly suggests a UTI.
- Aseptic leukocyturia (sterile pyuria): leukocytes present but culture negative or very low—often contamination, inflammation, stones, or organisms not picked up on routine culture.
- Isolated leukocyturia: leukocytes noted without clear bacteriuria—common in pregnancy, repeating a clean sample is often the next step.
Leukocyturia during pregnancy: dipstick vs microscopy (why results can differ)
Dipstick leukocyte esterase: useful screening, not a diagnosis
Dipsticks detect leukocyte esterase, an enzyme linked to white blood cells. It is helpful for screening, especially in busy OPDs. But it cannot confirm infection by itself.
False positives are common in Leukocyturia during pregnancy, mainly because vaginal discharge can contaminate the sample.
Microscopy: WBC/HPF and clues of contamination
Microscopy counts cells directly (often as WBC/HPF). It may also show:
- many epithelial cells (often a clue that the sample was contaminated)
- bacteria or yeast (not always diagnostic, but supportive)
If the report doesn’t match how you feel, repeating the test with careful collection can make interpretation much clearer.
Why leukocyturia is more common during pregnancy
Pregnancy changes the urinary tract in ways that make inflammation and infections more likely:
- Progesterone relaxes smooth muscle → ureters dilate, urine flow slows.
- The growing uterus can compress the bladder and ureters.
- Urinary stasis increases → urine stays longer, so the “flushing” effect reduces.
This is why Leukocyturia during pregnancy can show up even with mild or no symptoms—and why clinicians take urine findings seriously.
Common causes of leukocyturia in pregnancy
Urinary tract infection: cystitis and pyelonephritis
When symptoms are present, the most common reason for Leukocyturia during pregnancy is a UTI.
- Cystitis: lower UTI (bladder)
- Pyelonephritis: upper UTI (kidneys)
The most frequent organism is Escherichia coli, though other bacteria can also be responsible.
Asymptomatic bacteriuria: bacteria without symptoms
Some women have bacteria in urine culture but feel completely fine. This is asymptomatic bacteriuria, and it is specifically screened for during pregnancy.
Why treat if there are no symptoms? Because in pregnancy, asymptomatic bacteriuria increases the chance of pyelonephritis and is associated with obstetric complications. Treating it reduces risk.
Leukocyturia with a negative culture (sterile pyuria): frequent explanations
If Leukocyturia during pregnancy appears but culture is negative, common reasons include:
- contamination from vaginal secretions (very common)
- vulvovaginal inflammation spilling white blood cells into the sample
- a urinary stone causing irritation (sometimes one-sided back pain)
- organisms not detected on standard culture, depending on the context (for example chlamydia, mycoplasma, ureaplasma)
Symptoms to watch: recognising a UTI in pregnancy
No symptoms: yes, it can happen
Leukocytes may be found on routine testing even when you feel well. The two common explanations are:
- asymptomatic bacteriuria (confirmed on culture), or
- contamination/non-infectious inflammation.
So a dipstick alone should not label you as “infected.” The clinical picture and culture guide decisions.
Cystitis symptoms: burning, urgency, pelvic heaviness
Typical bladder infection symptoms:
- burning/pain while passing urine (dysuria)
- passing urine frequently in small amounts, with urgency
- suprapubic heaviness or discomfort
- sometimes blood in urine
Pregnancy itself causes frequency. A helpful question: “Is it new, painful, and associated with irritation?” If yes, call your maternity team.
Pyelonephritis symptoms: fever plus flank/back pain
Pyelonephritis in pregnancy needs rapid assessment. Typical signs:
- fever (often ≥ 38°C) with chills
- flank/back pain
- nausea or vomiting
- marked fatigue, feeling unwell
Fever plus back/flank pain is a reason to seek care without delay.
Tests used in pregnancy: dipstick, urinalysis, and culture
Dipstick nitrites: how to read them
Dipsticks also check nitrites, produced by some bacteria (commonly gram-negative bacteria like E. coli).
- Leukocytes plus nitrites: strong suspicion of bacterial UTI.
- Nitrites negative: does not rule out infection (not all bacteria produce nitrites, urine needs time in the bladder, vitamin C can interfere).
- Leukocytes alone: in Leukocyturia during pregnancy, contamination is common, so confirmation matters.
Urine culture: the reference test
A urine culture identifies:
- level of bacteriuria
- the organism
- the antibiogram (which antibiotics are likely to work)
Because sample quality affects results, collection technique is not a small detail.
How to collect a clean-catch midstream sample (Indian clinic-friendly steps)
A reliable sample usually includes:
- wash hands
- gently clean the vulva with water (or mild soap if advised), then rinse
- start urinating into the toilet
- collect midstream urine into a sterile container (avoid touching inside)
- close immediately and send to the lab as soon as possible
If heavy discharge is present, your clinician may suggest repeating the sample or sometimes collecting under guidance.
Interpreting leukocyturia in context: what usually happens next
Isolated leukocyturia: repeating the test is often the safest next step
For many women, Leukocyturia during pregnancy is simply an imperfect sample.
Before starting antibiotics, your team may suggest repeating urinalysis and culture, especially if:
- there are no urinary symptoms
- the culture is negative
- it is a first episode
This avoids unnecessary antibiotics while keeping you and baby safe.
Leukocyturia plus urinary symptoms: cystitis is likely
When Leukocyturia during pregnancy comes with burning/urgency, cystitis is the leading possibility. Treatment may be started quickly, then adjusted once the culture and antibiogram are available. The timing matters: treating early reduces the chance of infection ascending to the kidneys.
Leukocyturia plus fever or flank pain: urgent evaluation
Fever and flank/back pain with leukocyturia need priority evaluation because kidney infection can worsen quickly in pregnancy.
Treatment and follow-up during pregnancy
Confirm when possible, then choose a pregnancy-compatible antibiotic
Whenever possible, treatment is guided by culture and antibiogram. The aim is effective treatment with the narrowest, safest antibiotic choice.
Cystitis and asymptomatic bacteriuria: treat, then recheck
In pregnancy, clinicians usually treat confirmed infection even if symptoms are absent, to reduce the risk of pyelonephritis.
Depending on gestational age, organism, allergies, and local protocols, options may include:
- fosfomycin trometamol (often a single dose for uncomplicated cystitis)
- oral cephalosporins
- amoxicillin if the organism is susceptible
- nitrofurantoin in selected situations (typically lower UTI, with timing precautions)
A follow-up urine culture is often advised 1–2 weeks after finishing treatment, especially after asymptomatic bacteriuria, recurrent UTIs, or persistent symptoms.
Pyelonephritis: more intensive care is often needed
For pyelonephritis, teams often advise:
- hospital admission at least initially
- IV antibiotics followed by oral antibiotics
- monitoring hydration, temperature, pain, and fetal wellbeing
If recovery is slow, clinicians may check for a stone or obstruction.
Risks, prevention, and when to seek urgent care
Why clinicians take leukocyturia seriously in pregnancy
An untreated urinary infection can progress to:
- pyelonephritis
- maternal sepsis
- increased risk of premature rupture of membranes
- association with preterm birth and fetal growth restriction in infection-related cases
These risks explain why Leukocyturia during pregnancy is evaluated carefully, even when the report looks “mild.”
Everyday prevention habits that can help
Helpful habits:
- drink water regularly (unless fluid restriction was advised)
- don’t hold urine for long periods
- urinate after intercourse if prone to cystitis
- gentle external hygiene (avoid internal cleansing)
- manage constipation (it can worsen pelvic pressure and urinary stasis)
If UTIs repeat, your doctor may plan closer urine monitoring through the rest of pregnancy.
When to contact your care team urgently
Seek prompt assessment if you develop:
- fever ≥ 38°C, chills
- flank/back pain, especially with fever
- vomiting, severe weakness, signs of dehydration
- regular contractions, unusual abdominal pain, fluid leakage
- reduced fetal movements
- intense urinary symptoms or symptoms not improving
Key takeaways
- Leukocyturia during pregnancy means white blood cells in urine, it can reflect infection, inflammation, stones, or sample contamination.
- Pregnancy increases urinary stasis and the risk of UTIs, sometimes without symptoms.
- Dipsticks help screen, but urine culture with antibiogram confirms and guides treatment.
- Asymptomatic bacteriuria is treated during pregnancy to reduce the risk of pyelonephritis.
- Fever, flank/back pain, vomiting, contractions, fluid leakage, or reduced fetal movements need rapid medical evaluation.
- For personalised guidance and free health questionnaires, you can download the Heloa app.
Questions Parents Ask
Can leukocyturia be “normal” during pregnancy if I feel fine?
Reassuringly, yes—this can happen. Pregnancy often increases vaginal discharge and makes urine samples easier to contaminate, which may raise white blood cells on the report. If you have no burning, fever, or back pain, your clinician may simply suggest repeating a clean-catch midstream sample and sending a urine culture before considering any treatment.
What does “leukocytes 1+ or 2+” on a urine dipstick mean?
A “+” result usually reflects leukocyte esterase, a screening marker linked to white blood cells. It can point toward irritation or infection, but it doesn’t confirm a UTI on its own. Many parents see “2+” and worry—understandably. Still, the next step is often to look at symptoms and confirm with microscopy and culture, especially if nitrites are negative or you feel well.
What is the normal range of leukocytes in urine during pregnancy?
Ranges vary by lab and method (dipstick vs microscopy vs automated counting), so comparing your result with the lab’s reference range matters most. Many labs consider leukocyturia more meaningful above a certain threshold (often reported as WBC/HPF or cells/mL). If the report also shows lots of epithelial cells, it often suggests contamination—so repeating the test can quickly clarify what’s really going on.
Further reading :
