Enlarged blood cells during pregnancy

The white blood cell count reduced (leukopenia)

Leukocytes – white blood cells, different in form. Their main function – protection against external and internal pathogenic agents. Increasing the level of leukocytes in the blood is called leukocytosis, and a decrease – leukopenia. Low level of white blood cells indicates a sharp decline in immunity.

Normal white blood cell count

Distinguish 5 types of leukocytes: neutrophils, eosinophils, basophils (granulocytes), monocytes, and lymphocytes. In the General analysis of blood of a healthy person the number of leukocytes ranges from 4 to 9 *109/l.

The ratio of forms called leukocytes leukocyte formula. Women and men it looks about the same:

  • eosinophils 2-4%;
  • basophils 0-1%;
  • myelocytes and young shape – 0%;
  • stab 2-5%;
  • segmented 55-67%;
  • lymphocytes 20-35%;
  • monocytes 4-8%.

To assess the status of the child, these norms are not suitable. In children, WBC labile and the ratio of blood cells depends on age. White blood cells in a child before puberty more than adults. About radiation in children can speak in that case, if the content of white blood cells below 4.5 х109/L.


Leukopenia is divided according to duration in:

  • Acute – less than 3 months;
  • Chronic – from three months or more.

Chronic leukopenia is subdivided into congenital, idiopathic (arises independently and not compared to other diseases), cyclic and autoimmune.

Also there are three degrees of severity (depending on the level of white blood cells):

  • mild (1 to 1.5 x 109/l);
  • medium level (0.5 to 1 x 109/l);
  • severe (less than 0.5 x 109/l ).

Physiological leucopenia

In rare cases there is a physiological decrease in the level of white blood cells. Less than 10% of people of Caucasian race with no signs of organic or functional pathology of the bone marrow can determine the decrease of leukocytes up to 2 x 109/L.

The temporary reduction of the level of white blood cells may occur during sleep (activation of the vagus nerve), after visiting baths or saunas, during strong emotional arousal. The cause of the physiological decline in white blood cells is to move part of the formed elements in other areas of the vascular channel, for example, when expressed limited inflammatory process.

Pathological leucopenia

Changes in the leucocyte count might be due to a General decline in the level of leucocytes, and in the lack of a certain type of white blood cells. Also allocate their increased destruction or decreased production. The causes of this condition are different.

You first need to evaluate bone marrow. The white blood cells reduced in its aplasia or hypoplasia. This condition is congenital, and may be the result of the influence of chemical substances or medicines.

A significant reduction in white blood cells observed in conditions of immunodeficiency, namely with the progression of the acquired immunodeficiency syndrome caused by human immunodeficiency virus. On the basis of blood content of CD4 lymphocytes is diagnosed, the stage of the disease, defined indications for antiretroviral therapy.

Also sharply reduced the number of white blood cells when exposed to ionizing radiation of different intensity. Radiation primarily affects the body, whose cells are actively and rapidly dividing. Blood-forming organs the top of the list. The severity of leukopenia depends on the extent of damage by ionizing radiation.

Low leukocyte count is a marker of viral diseases (typhoid fever, paratyphoid fever) and childhood infections (measles, rubella, mumps). Also leukopenia is observed with a deficiency of b vitamins (B1, B12), iron, folate, and copper. In women leukopenia may develop on the background pathology of the reproductive system.

The formation of neutrophils affected by oncological pathologies, hereditary diseases, aplastic anemia. A massive destruction of white blood cells in adults occurs in diseases characterized by enlargement of the spleen (Hodgkin’s disease, viral hepatitis, liver cirrhosis and others).

You should periodically check the level of neutrophils with prolonged use of these drugs: NSAIDs, tricyclic antidepressants, antipsychotics, anticonvulsants, and antihistamines.


We must highlight the agranulocytosis. This is a condition in which there is a sharp decrease in the number of granulocytes in the peripheral blood. It dramatically increases the susceptibility to various bacterial and fungal infections. In 75% of cases it ends in death.

It develops under the influence of toxins or radiation to the red bone marrow and cancer (myelotoxic agranulocytosis). Also hematologists distinguish autoimmune agranulocytosis and one that occurs under the influence of drugs, for example, sodium metamizol (dipyrone).

Leukopenia asymptomatic. Reduced immunity provokes accession fungal or viral diseases. The lower the level of white blood cells and the faster it decreases, the more the patient susceptible to opportunistic infections accession. These include Pneumocystis pneumonia, candidiasis, intestinal dysbiosis.

The patient complains of General weakness, fatigue, dizziness, shortness of breath. Sometimes joining dyspepsia – nausea, vomiting, heartburn. There has been a rapid increase in temperature in case of bacterial infections. The lymph nodes and tonsils increase in size, on palpation, splenomegaly (enlarged spleen).

Patients with leukopenia should be strictly isolated and kept in a separate box or a single ward. It is important to prevent the accession of opportunistic infections.

The therapy of the underlying disease that caused the decrease in the content of leukocytes. In violation of the formation of neutrophils prescribed stimulants leykopoeza.

For the treatment used methyluracil as a stimulator of tissue growth and immunity. Pyridoxine is used when the lack of b vitamins, if this is the cause of the disease.

New Health Advisor

Red blood cells are one of the most important parts of the body as they carry oxygen between your lungs and the various cells in your body. This is why people with a low red blood cell count will feel it significantly and even show it. They may be weak, tired, and pale or have issues catching their breath. This information should help you better understand what is going on and what you can do.

What Is the Normal Red Blood Cell Count Range?

The most common cell type in your blood is the red blood cell. There are millions and millions of red blood cells, which are disc-shaped. The bone marrow of healthy adults will continuously produce them. Red blood cells contain hemoglobin, a substance responsible for bringing carbon dioxide and oxygen throughout your body.

The red blood cell count, or RBC count, lets you know if you have a low amount of red blood cells, which is known as anemia, or a high amount, which is known as polycythemia. There are many possible causes of low red blood cell count, such as chronic blood loss leading to iron deficiency anemia, acute blood loss, or hereditary disorders. High RBC levels, on the other hand, are fairly uncommon.

The optimal range for an average person will be between 3.95 and 5.35 M/mm3, but it varies by person, gender, and age. These figures from webmd show specific ranges for given groups.

Normal Red Blood Cell (RBC) Count

4.5 to 5.5 million RBCs per microliter (mcL) or 4.5–5.5 x 10 12 /liter (L)

4.0 to 5.0 million RBCs per mcL or 4.0–5.0 x 10 12 /L

Pregnancy values should be slightly lower

3.8 to 6.0 million RBCs per mcL or 3.8–6.0 x 10 12 /L

4.1 to 6.1 million RBCs per mcL or 4.1–6.1 x 10 12 /L

Signs and Symptoms of Low Red Blood Cell Count

Fatigue or tiredness is the most common of all symptoms associated with having a low red blood cell count. This is due to the lack of hemoglobin within the blood since this iron-rich protein is found in your red blood cells and carries oxygen throughout the body.

Other symptoms of a low red blood cell count may include dizziness (particularly when standing), shortness of breath, headaches, pale skin, chest pain, and coldness in the hands or feet.

When there aren’t enough red blood cells in your body to carry hemoglobin, your heart has to work even harder so the lower amount of oxygen in your blood can be moved. This may lead to heart failure in severe cases or less serious issues such as an enlarged heart, a heart murmur, or irregular heartbeats (arrhythmias).

Complications of Low Red Blood Count

When you have a low red blood cell count, your blood has a reduced capacity to carry oxygen and its viscosity is also reduced. Your blood is therefore “thinner” and can move more quickly because of the lack of resistance among the body’s blood vessels. This in turn causes more blood to flow through your heart in a single minute than typically does, known as increased cardiac output. The blood also carries less oxygen so your blood vessels dilate, further reducing resistance and increasing the speed of blood flow.

During exercise or other times of increased demand, your body can’t cope because of your low red blood cell count. Your heart will try to beat faster and will increase your breathing rate so your tissues get enough oxygen. This is frequently not enough, leading to tissue injury or even acute heart failure.

Causes of Low Red Blood Cell Count

1. Red Blood Cell Loss

Bleeding is a common cause of red blood cell loss. It may happen quickly, such as from surgery, frequent blood draws, or an injury. It may also occur slowly and chronically, such as from heavy menstruation or a lesion in your intestinal system leading to bleeding.

2. Increased Destruction

Bone marrow produces red blood cells which then circulate for around 120 days in the bloodstream with damaged or old cells being removed by your spleen. Various diseases may cause excess damage to blood cells or make the spleen remove them too early. Some possibilities include autoimmune hemolytic anemia and sickle cell anemia.

3. Inadequate Production

There are also diseases, drugs, and infections which can interfere or damage the bone marrow cells responsible for producing mature red blood cells. Some examples include chemotherapy, myelodysplasia, or scarring of the bone marrow.

4. Other Causes

Other potential causes of a low red blood cell count include:

  • Anemia
  • Bone marrow failure
  • Bleeding
  • Erythropoietin deficiency due to kidney disease
  • RBC destruction from blood vessel injuries or transfusions
  • Malnutrition; nutritional deficiencies of vitamins B6 or B12, folic acid, copper, or iron
  • Leukemia
  • Multiple myeloma (bone marrow cancer)
  • Pregnancy
  • Overhydration

Treatment for Low Red Blood Count

The treatment for a low red blood cell count will depend on the causes and symptoms. If anemia is the cause and you have cancer, you may need a red blood cell transfusion.

If it is due to anemia, you may receive drugs that stimulate the production of erythropoietin or supplement it. These can be given as injections and take several weeks to start working.

Anemia from malnutrition may require oral or IV supplements. You may also be directed to eat foods with folic acid or iron.

What You Can Do About Low Red Blood Cell Count

You can also do some simple things on your own to improve your red blood cell count.

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Rh Sensitization and Pregnancy

Your Blood Type

Red blood cells (RBCs) are especially important to the body because they carry oxygen from the lungs to the rest of the body, and remove carbon dioxide waste. On the surface of each RBC is a set of proteins. Which proteins you have is determined genetically.

When doctors talk about these proteins, they refer to them as your “blood type.” Everyone has a blood type. One familiar set of proteins used in blood typing refers to the A, B, O system. Your blood type may be A, B, AB, or O.

A second familiar blood typing system describes the presence or absence of Rh protein. (It’s called “Rh” because it was first noticed in Rhesus monkeys.) If you have the Rh protein, you are Rh-positive. If you don’t have it, you are Rh-negative. Everyone is either Rh-positive or Rh-negative.

Your Immune System

Your immune system functions to protect your body from infection. In order to do that, it must be able to tell when something doesn’t belong in your body, then get rid of it. The immune system uses a complex system to identify what is “self” (or what’s supposed to be there) and what is “nonself” (or what is foreign and probably dangerous). Anything that the immune system identifies as foreign is called an antigen. To protect the body, the immune system marks all antigens to be destroyed.

When your immune system detects an antigen, it produces an antibody specific to that antigen. Antibodies circulate in your blood and destroy antigens. After the initial exposure, they can quickly recognize their specific antigen and react to have it destroyed if it reappears. Antibodies speed up the immune system’s response to infection. Vaccines work on this principle that the immune system produces antibodies in response to a small exposure to an antigen.

Your Immune System and Your Blood Type

In the blood, your immune system uses the proteins on the surface of the RBCs to identify the cells that belong in your body. That’s why your blood type is important during transfusions, because the immune system will destroy any blood that you receive that it doesn’t recognize. An incompatible blood transfusion can result in severe illness and even death. If you receive a transfusion of compatible blood, your immune system can’t tell the difference between the blood you received and the blood your body produced.


Exposure to an incompatible blood type causes the body to produce antibodies. When an Rh-negative person is exposed to Rh-positive blood, his or her body produces antibodies to the Rh factor in the blood. This reaction is called “Rh sensitization.” It is important for Rh-negative women because it affects pregnancy.

Hemolytic Disease of the Newborn

During pregnancy, the mother’s antibodies cross the placental barrier and enter the blood of the fetus. If the mother is Rh-negative and has been Rh-sensitized through exposure to Rh-positive blood, she has antibodies to the Rh factor. If her baby is Rh-positive, the mother’s antibodies attack the fetus’ RBCs, and the baby is born with a disease called “hemolytic disease of the newborn” (or HDN), or erythroblastosis fatalis.

The symptoms of HDN result from a low RBC count. With fewer RBCs, the infant’s blood has a lowered ability to carry oxygen to the body. The newborn’s body tries to compensate for its anemic condition and tries to produce a large number of RBCs in a short amount of time, creating other problems in the body, especially the liver. The liver becomes overworked in trying to keep up with the production of new RBCs and the cleaning away of the dead blood cells. It becomes enlarged and unable to keep up. The dead blood cells form bilirubin and result in jaundice. Fluid also begins to accumulate in the stomach, lungs, and around the heart, giving the baby a swollen look. HDN may be fatal in the most severe cases. All of these symptoms are a direct result of the mother’s antibodies attacking the infant’s red blood cells.


Preventing Rh sensitization, and thus preventing HDN, is a part of routine prenatal care. Sensitization can be prevented by giving the Rh-negative woman an injection of Rh Immune Globulin (RhIg), such as Rhophylac, at the twenty-eighth week of pregnancy and another 72-hours after delivery. An RhIg preparation is also given after any possible exposure to Rh-positive blood.

Exposure to Rh-positive blood can occur not only through incompatible transfusions, but also through carrying an Rh-positive baby. Blood may mix in the course of pregnancy during delivery, miscarriage, abortion, Ectopic (or tubal) pregnancy, amniocentesis, abdominal trauma, external manipulation of the uterus such as trying to turn a breech baby, or even across the placenta. In any pregnancy in which an Rh-negative woman carries an Rh-positive baby, there is a risk of Rh exposure and sensitization. If the father is known to be Rh-negative, there is no danger of HDN or Rh sensitization because the fetus will also be Rh-negative.

There is little risk of a woman becoming Rh-sensitized and then affecting her fetus during her first pregnancy. RhIg injections are given after each delivery to protect future pregnancies. The RhIg works to clear away any antigenic cells that may have entered the mother’s body, preventing antibody-formation.

Standard prenatal care involves the testing of a woman’s blood for Rh antibodies. If she is found to be Rh-sensitized already, no RhIg will be administered because it will not have any effect. Upon delivery, the baby will be watched closely for symptoms of HDN and will be treated accordingly.

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