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Am pregnant, done blood and urine tests. Worried about Rubella and pus cells in urine

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Practicing since : 1997
Answered : 1031 Questions
Hello Doctor
My wife is 9 week pregnant. This is her first pregnancy. We had several blood and urine tests at our first antenatal visit to doctor. The lab results at week 5 reported following results (which were out of normal reference ranges):
Urine Routine Examination:
Ketones - Traces (5 mg/dl) [Ref range - NIL]
Leucocyte Esterase - Positive [ReF Range - NEGATIVE]
Pus Cells - 5-7 WBC/HPF [Ref Range - 0-5 WBC/HPF]
Epithelial Cells - +++ (In Large Numbers) [Ref range - NIL]

Rubella Antibody Panel IgG and IgM
Rubella IgG - 131.10 IU/ML [Ref Range - 0.00 - 4.99]
Rubella IgM - 0.22 Index [Ref Range <1.20]

Above tests were performed on 12-May-12. After consultation with doctor, we conducted Rubella IgG Avidity, Urine Culture and Urine Routine on 9-Jun-12, and below are the lab results:

Rubella Avidity IgG (EIA) - 87.66%
Urine Culture - No growth after 48 hours of aerobic incubation at 37 deg C.
Urine Routine :
S.G. - 1.030 [Ref Range - 1.001 to 1.030]
Ketones - NIL [Ref range - NIL]
Leucocyte Esterase - Positive [ReF Range - NEGATIVE]
Pus Cells - 18-20 WBC/HPF [Ref Range - 0-5 WBC/HPF]
Epithelial Cells - ++ (In Fair Numbers) [Ref range - NIL]

I would request you to please elaborate the lab results above, comparing two reports. I am bit worried about this Rubella and Pus Cells in Urine. It would be very helpful if you can interpret those to me.

Thanks a lot in advance for your time and help.

Best Regards
Posted Thu, 28 Jun 2012 in Pregnancy
Answered by Dr. Kulsoom Qureshi 57 minutes later
Thanks for consulting us & providing a detailed account of her lab results.
I have seen the lab results you attached & my interpretation is as under.
Your wife is immune to rubella due to some past infection ( This is the case in more than 90% of pregnant women ). That is, she & her pregnancy is unlikely to be affected by Rubella if she is exposed to it during her antenatal period. So, this is a normal healthy result.
As far as her urine test is concerned, I would say a little clinical correlation is required. As the culture is negative we cannot say that she is having a pus cells so this result need to be interpreted with caution. I would like to know:
Is she having some vaginal discharge?
Is she having any urinary tract symptoms?
Does the collection of urine sample was made using the standard precautions? ( for a proper result a clean catch mid stream sample of urine is required otherwise discrepancies often arise in the results).
I can make any further comment only after getting answers about above questions. So your follow up query is awaited.
Presence of ketones may indicate dehydration which is common if patient is not taking enough water due to her morning sickness. This can be corrected by telling her to take good amount of water.
All other tests are normal & no specific action is required at the moment.
I hope I have helped you a little. Please write back if you want to discuss this further. I will be happy to respond.
Wishing you best of luck.
Best Regards.

Above answer was peer-reviewed by
Follow-up: Am pregnant, done blood and urine tests. Worried about Rubella and pus cells in urine 12 minutes later
Dear Doctor Kulsoom
Thanks a lot for your detailed response. Please find below the answers to the questions you asked:
Currently she is not having any vaginal discharge; However, Yes, It was there couple of weeks ago. I think in Mid of May, she had some whitish liquid vaginal discharge for 3 to 4 days, but it stopped then, and since then no vaginal discharge. At the same time she was having itching/ and burning sensation while urination, but this was also at the same time when she was having whitish vaginal discharge, This symptom also stopped with the stop of this vaginal discharge.
Other than this there is no other UT sypmtoms as such.
Urine sample collection was done at the lab itself; however she told me that the wash room where she collected sample was not very higynic, thats the only information I have.
I hope I could manage to provide you the required information for you to comment on it. Please suggest your observation.

Best Regards
Answered by Dr. Kulsoom Qureshi 5 hours later
Thanks for your response. I have got the desired clue.
So, now the picture is very clear. The abnormalities in urine report are likely to be due to contamination with vaginal discharge coupled with improper sample collection.
As she currently has no urinary symptoms as well as no vaginal discharge therefore I can reassure you that there is nothing to worry about.
However if you need a proof she may go for a repeat urine detailed examination.
Correct method of sample collection is to bring a sterilized container from lab.
Clean the area with tap water.
Discard first few ml of urine into toilet & collect the midstream specimen into the container again wasting the terminal flow of urine.
Better collect it at your home.
Sample collected this way are more likely to provide realistic results.
Hope this answers your question.
If you still need any more information please write back. I will be there to answer.
Wish you good health
Best Regards
Above answer was peer-reviewed by
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