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Pregnant. Blood Test, Peripheral Smear And Urine Analysis Done. What Are The Findings?

Posted on Wed, 6 Feb 2013

Question: My wife is in 1st trimester of her pregnancy and we got all the required test done last week. The reports summary is here:

Blood Test
HB: 12.3 g/dl (11.5 - 16.5 g/dl)
PCV : 36.9 % (37-47 %) - ABNORMAL VALUE

RBC : 4.12 millions/cumm
MCV : 87.1 fl (76 - 96 fl)
MCH : 28.6 pg (27 - 32 pg)
MCHC : 33.4 g% (32 - 36 g%)

Total Count : 10, 800 cells/cumm (4000 - 0000 cells/cumm) - ABNORMAL VALUE
Neutrophils : 72% (40 - 75%)
Lymphocytes : 14% (20 - 45%) - ABNORMAL VALUE
Eosinophils : 02% (0 - 6%)
Monocytes : 02% (2 - 8%)
Platelet count : 1.90 Lakhs/cumm (1.5 - 4.5 Lakhs/cumm)
ESR : 20 mm/hr (0 - 20 mm/hr)

Peripheral Smear
RBCs : Normocytic Normochromic
WBCs : Normal in morphology
PLATELETS: Adequate
HAEMOPARASITES: Not Seen
ABNORMAL CELLS: Not Seen
IMPRESSION: NORMOCYTIC NORMOCHROMIC BLOOD PICTURE

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Randam Blood Sugar: 104 mg/dl (70-150 mg/dl)
Randam Urine Sugar: Nil
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VDRL: Non Reactive
HBSAG: Negative
HIV ELISA: Negative
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Urine Analysis:

Physical Examination
Volume: 25 ml (20-30 ml)
Color: Pale Yellow (Pale Yellow)
Appearance: Turbid (Clear)
Specific Gravity: 1.010 (1.008-1.028)
PH: 6.0 (5.2 - 6.7)

Chemical Examination
Albumin: Trace (Negative)
Sugar: Negative (Negative)
Ketone bodies: Negative (Negative)
Bile Salts: Negative (Negative)
Bile Pigments: Negative (Negative)
Urobilinogen: Normal Amount (Normal Amount)

Microscopic Examination
Epithelial Cells: 4-6/hpf* (2-3/hpf) - ABNORMAL VALE
PUS Cells: 8-10/hpd* (0-1/hpf) - ABNORMAL VALUE
RBC: Nil (Nil)
Casts: Nil (Nil)
Crystals: Nil (Nil)
Bacteria: Present (Nil)

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T3T4TSH
TRI-IDOTHYRONINE T3 : 166.29 ng/dl (60.00 - 181.00 ng/dl)
THYROXINE T4 : 9.90 ug/dl (4.50 - 12.60 ug/dl)
THYROID STIMULATING HORMONE TSH: 11.56 (H) uIU/ml (0.35 - 5.50 uIU/ml) - ABNORMAL VALUE

Certain paramaters like PCV, Total Count, Lymphocytes in Blood Test, Epithelial & PUS Cells with Bacteria presence in Urine Test, and high TSH value in Thyroid Test are a reason to worry.

She is in her 11 week and would be completing 12th on 24th of this month. So, planning to visit a doctor tomorrow but still I want to take an expert opinion on these reports.

Regards,
XXXXXXX

Answered by Dr. Rhea Chanda (48 minutes later)

Hello XXXXXXX
Some points to remember here are the following:
1.Total count is mildly raised,which is often seen in in pregnancy. Dont worry about that at present.Total count is raised in infection,and there may have been an infective focus in the recent past.
2.PCV depend on the Hb and thats normal.Nothing to worry about.
3.The problem lies in the urine report.Presence of pus cells and bacteria means that she may have an urine infection.She needs to get an urine culture done.It will detect any infection.
4.TSH is high,indicating hypothyroidism. She needs to start medication for that immediately and continue throughout pregnancy.
Rest of the reports are normal.
I suggest that she see her doctor asap for the thyroid meds and get the urine culture done also.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar