Interpretation of the leukocyte blood profile during pregnancy: separating the norm from the pathological

The article is devoted to the interpretation of idiopathic changes in the leukocyte profile in women with normal pregnancies, mimicking the signs of complicated infection. It is argued that neutrophilic leukocytosis and a left shift to myelocytes in the second half of pregnancy are manifestations of the physiological systemic inflammatory response syndrome, induced by the pleiotropic effects of proinflammatory placental cytokines. A discussion of a clinical example demonstrates that myeloid type of leukemoid reaction, in the absence of severe infection, intoxication, or a clinically significant inflammatory focus, is a reversible, benign gestational abnormality. This laboratory diagnosis does not require extensive screening or treatment. The author emphasizes that misinterpreting the described changes as pathological leads to false diagnoses and antibiotic prescriptions for patients with normal pregnancies. This leads to the development of antibiotic resistance, polypharmacy, and increases the drug burden on the mother and fetus. The tactic of managing pregnant women with deviations in the leukocyte blood formula beyond the routine values is covered.