The composition of the blood is sensitive to changes in the body that occur in a pregnant woman. Therefore, a blood test is a common procedure for diagnosing the condition of a pregnant woman. Characteristics of the blood condition are an important indicator. Among determining the concentration of hemoglobin, leukocytes, erythrocytes and others, special attention is paid to a blood test for ESR during pregnancy. What does ESR mean in pregnant women and what does it affect?
ESR - what is it
The abbreviation ESR stands for erythrocyte sedimentation rate. This is the most important biochemical blood indicator, changes in which often indicate the development of an inflammatory process. When carrying a baby, the female body experiences serious stress, so to monitor the health of a pregnant woman, it is necessary to undergo regular blood tests. An ESR study during pregnancy is mandatory. These blood cells take an active part in transporting oxygen supply to all intraorganic structures.
The main part of red blood cells is hemoglobin, which gives blood its color. The calculation of the erythrocyte sedimentation rate is carried out by mixing blood with an anticoagulant, under the influence of which the erythrocyte bodies sink to the bottom of the container. The number of erythrocyte structures that have settled into sediment per hour will be an indicator of ESR. Of course, it is impossible to diagnose any pathology only by the rate at which erythrocyte sedimentation occurs. However, its changes may indicate the development of inflammation.
Erythrocyte sedimentation rate value
Erythrocyte blood cells perform essential functions, delivering the necessary nutrition and oxygen to the body's cells. They are elastic and have no cores, which allows them to percolate through small capillary walls. The erythrocyte sedimentation rate is not a specific blood indicator and is not interpreted separately, since it sometimes increases for a number of physiological reasons.
- For example, in newborn babies this indicator is quite low, and by adolescence it is equal to the ESR of an adult. By reaching old age, red blood cells begin to settle much faster, i.e. ESR increases.
- Some physiological conditions can also affect this indicator, we are talking about an increase in ESR during pregnancy. During pregnancy, a lot of changes occur in the female body, which also affect the hematopoietic system.
- The biochemistry of pregnant and non-pregnant patients is very different. A laboratory blood test will show that during pregnancy, hemoglobin levels fall and ESR increases. It is the mother's red blood cells that supply the baby with oxygen and nutrients.
Red blood cells do not live long, only 120 days, after which they die in the spleen or liver, and are replaced by new red cells produced in the bone marrow structures. In the blood they are in suspended form, do not stick together and cannot be attracted, but when red cells enter an unnatural environment for them, they begin to precipitate. At first, weak and damaged red blood cells settle.
When biochemistry is being tested, blood is placed in a test tube and sodium citrate is added to prevent it from clotting. The biomaterial settles for an hour, then the height of the sedimentary column, which was formed during the settling of red cells, is recorded.
Standards
A blood test in pregnant women is normal if the indicators correspond to the figures indicated below.
Red blood cells should be (3.5-5.6) ∙ 1012 cells/l. The test form indicates 3 average red blood cell values:
Average volume (MCV). It determines the type of anemia, if any. It should be 80-100 fl.;
Average hemoglobin content in erythrocytes (MCH). It is used to diagnose the type of anemia. It should be within 26-34 pg;
Red blood cell hemoglobin concentration (RBC) indicates the severity of hemoglobin formation disorders. Results should be between 31-36 g/dL. If MSHC is low, but red blood cells and hemoglobin are normal, this means the study was carried out incorrectly.
Leukocytes should be between 3.2 and 10.2 *109 cells/l in a healthy person. Fluctuations within the range of (4.0-9.0) ∙ 109 cells/l for pregnant women in the first trimester are considered natural. For the second trimester, the standards are different - up to 11.0 ∙ 109 cells/l. Well, in recent months, the standard level of leukocytes is even higher and is already up to 15.0 ∙ 109 cells/l. This happens because the protective functions in the female body are enhanced during this period.
Reticulocytes should be between 0.12-2.05%. When undergoing prevention of folate and iron deficiency anemia, there are sharp increases in the level of reticulocytes, which shows the effectiveness of the procedures and the course of treatment as a whole. This happens when taking medications for anemia. A high level of young red blood cells can also occur after bleeding caused by a threatened miscarriage.
The color index should be 0.85-1.2.
Under normal pregnancy conditions, hemoglobin should be at least 110 g/l. Low hemoglobin levels during pregnancy, which may be associated with more intensive blood circulation, in combination with previous red blood cell readings, are also considered normal. But it’s still worth taking care of its level. Below are the standards by period:
I trimester – 112-160 g/l;
II trimester – 108-144 g/l;
III trimester – 100-140 g/l.
Hematocrit Its value should be 31-49%. If the results form shows that the hematocrit percentage is decreasing, and the blood volume and red blood cells are increasing, there is no need to worry; this is a completely normal situation when a woman is pregnant.
Fluctuations in ESR should be within 10-45 mm/h. Such a high value is normally unacceptably high for a non-pregnant woman: usually the ESR value does not exceed 20 mm/h.
This transcript of the analysis should help you understand the results of the study and understand what your gynecologist will talk about at the appointment. To summarize the information provided and for your convenience, a table is provided below.
Normal ESR during pregnancy
For non-pregnant patients, the normal erythrocyte sedimentation rate is 15 mm/h, but with the onset of conception, these data change. Moreover, at different trimesters of gestation the level of ESR changes noticeably. In the first months (up to 12 weeks), a slightly increased ESR is observed - 11-21 mm/h. During the second trimester, the erythrocyte sedimentation rate increases even more and is already 20-30 mm/h. By the third trimester, ESR levels increase again, reaching 50 mm/h.
After conception, the ESR may drop slightly, and then increase abruptly with the development of the fetus. Typically, indicators remain within normal limits or drop slightly during the first 6 months, and begin to increase by the arrival of the third trimester. In general, ESR standards during pregnancy are ambiguous and are very average. Deviations occur even in completely healthy patients. The exact indicators of erythrocyte sedimentation rate depend on the individual characteristics of the woman.
It must be taken into account that a speed of 50 mm/h is normal only for the third trimester, which lasts from 28 to 40 weeks. If a similar indicator is observed in a pregnant woman in the early stages, then it should be regarded as a suspicious sign. In such a situation, it is necessary to undergo additional diagnostics.
Deviations from the norm in a clinical blood test - and how to treat them
Individual deviations in the test results should be interpreted by the attending physician. Although the deviation itself is a disturbing fact, the cause and method of eliminating the deviation can only be determined through analysis.
Note! All changes are provided for informational purposes only. Any deviations from the given data are possible and may be the norm, but falling within the norm may not be the norm. Only an observing doctor can interpret the results most fully!
Why is it rising?
Closer to the time of birth, fibrinogens are activated in the maternal blood and the body begins to prepare for childbirth. To prevent bleeding, the blood greatly changes its structural characteristics, including acquiring a high ESR. There are many reasons that provoke an increase in the erythrocyte sedimentation rate.
- The main reasons for an excessive increase in ESR are associated with decreased hemoglobin levels. IDA during pregnancy is a fairly common condition due to increased oxygen supply requirements.
- Reduced ESR levels are also observed in active vegetarians, since a deficiency of animal proteins leads to disruption of hematopoietic processes.
- Colds and rheumatological pathologies, bleeding of various etiologies or oncopathologies are also accompanied by an increased rate of red cell sedimentation.
- In addition, increased ESR is observed in pathologies of intestinal structures, inflammatory and infectious processes in the urinary organs, infectious infections or diabetes.
- Increased cholesterol, during the period of postoperative rehabilitation or post-traumatic condition, the erythrocyte sedimentation rate also increases.
In addition to pathological causes, completely peaceful physiological conditions can also temporarily affect ESR. For example, high air temperature. If it is too hot in the treatment room where the test is taken, or the mother took a hot shower before the test or spent a long time in the sun, then the red blood cells in the blood will begin to settle faster. Also, red cells behave abnormally after eating, which is why experts recommend taking all tests on an empty stomach. The sedimentation of red cells is also influenced by the patient’s psycho-emotional background. If she is afraid, worried or nervous, the analysis will show characteristic changes in the blood.
Additional diagnostics
The erythrocyte rate is an informative indicator, but it cannot act as evidence of the presence of pathology. To exclude false positive results, blood must be donated again. If the indicators are also elevated, the doctor evaluates the medical history to rule out physiological factors. Additionally, the woman will have to undergo additional diagnostic procedures.
With inflammation, leukocytes will be increased in the blood. To identify the localization of the pathological process, you will need to decipher the leukocyte formula. A blood test from a vein allows you to determine hormonal or metabolic problems. A urine test will help identify inflammation and infection in the genitourinary system, and if protein and leukocytes are found in the urine, then the causes should be sought in urinary and renal pathologies. The presence of bilirubin in the urine indicates liver problems or accelerated erythrocyte breakdown.
A bacterial culture of a swab from the throat, intestines, urine or vagina will reveal a bacterial infection. Additional ultrasound diagnostics is used to determine intraorganic pathologies. If the doctor has any concerns, he will refer the pregnant woman for an endocrinological, immunological or oncological consultation with a specialist.
Nuances of passing the analysis
Blood tests are taken from pregnant women in the morning, always on an empty stomach. The material is collected from a finger or from a vein. There is a difference in some indicators from venous and capillary blood, which is taken into account when performing the analysis.
As with any research, preparation is also needed to obtain reliable health information. Therefore, you need to follow the following rules for donating blood:
The day before visiting the laboratory, avoid eating fatty and smoked foods;
Do not take a hot bath 24 hours before. By the way, it is generally contraindicated for pregnant women;
Avoid physical and mental stress as much as possible.
How to normalize
Only the doctor should decide what to do with an increased erythrocyte sedimentation rate. If changes in indicators were provoked by pathological factors, then appropriate drug therapy will be needed. For anemia, vitamins and iron supplements are prescribed, and the pregnant woman’s diet is adjusted. If the ESR has fallen under the influence of a pathologically weak immune system, then the pregnant woman will have to reconsider her daily routine and rest more, walk in the fresh air and eat well.
In some cases, folk recipes such as beetroot infusion or linden tea, infusion of calendula or chamomile, etc. will help correct ESR levels. But even such harmless methods of treatment must be approved by a specialist, since during pregnancy, self-medication can harm not only the mother herself, but also her baby.
If elevated erythrocyte sedimentation rates are detected, you should not panic, especially for pregnant women. Often, such a diagnostic sign has a completely peaceful physiological origin and does not threaten either the mother or the baby growing inside.
