OutLine
- Introduction.
- Types
of tests.
- Basis
for the test.
- Home
pregnancy tests.
- Laboratory
confirmatory tests.
- False
Positives & Negatives.
- Other
prenatal tests.
- Viability
tests.
Introduction:
The earliest pregnancy test was based on early pregnancy
factor. This test can be performed within 48 hrs of fertilization but very
costly. But at present there are lot of ways to detect pregnancy at an early
stage. Tests are available to confirm pregnancy at home itself.
Types of tests:
Some of the confirmatory tests available now are;
- Home
pregnancy tests.
- Quantitative
serum analysis.
- Urine
analysis
- Qualitative
analysis.
- Sonograms.
- Physical
examinations.
Basis for tests:
Most chemical tests for pregnancy are based on the presence
of beta subunit of HCG or human chorionic gonadotrophin in the blood or
urine.HCG can be detected in urine or blood after implantation, which occurs
6-12 days after fertilization.
Trophoblast cells of the embryo which gets implanted in the
uterine endometerium secretes this hormone which is later continued by
placenta.
Quantitative blood analysis requires a minimum level of
1mIU/ml, of HCG to detect pregnancy when compared to urine test, qualitative
test which requires a level of 20mIU/ml n and a level of 25 mIU/ml
respectively. Thus the Quantitative blood analysis serves the best and is
highly sensitive.
Home pregnancy test:
Home pregnancy tests have become common nowadays. Though they
are very much helpful and fairly accurate, their results always should be
confirmed with a doctor.
- In
pregnancy, the growing tissues of the new conception (early foetus)
secrete a special hormone into your body called ‘Human Chorionic
Gonadotrophin’ (HCG). This enters your blood as early as 10-12days
following fertilisation. This can be traced from blood or urine by
special tests. Home tests are done with urine.
- Depending
upon the type and sensitivity of the test used, pregnancy can be detected
as early as a day or two from the missed period.
- Technique
for the usage of these tests will be included in the pack itself.
Usage:
These kits are user friendly. First
· Urine
should be collected in clean detergent free bottle.
Preferably first morning sample is used as it contains more
of HCG hormone levels.
· Urine
is then taken in the dropper given with the kid.
· Only
2/3 drops of urine are added to the well where it is indicated.
· If
there appears a pink line in the place indicated as tests and other pink in the
control region then the tests is positive.(2 pink lines).If only one line
appears in the test region then the test is negative, and if no lines appear
then the test is invalid.
· Method
of testing differs according to the brand.
It may happen that a test result comes negative although, in
reality pregnant. This is more likely if:
- The
cycles are irregular or are often delayed.
- The
testing has been done very early in pregnancy. In such cases, if the test
is repeated after one week, it may become positive. It is always advisable
to confirm the pregnancy diagnosis by a qualified medical practitioner as
all tests have their limitations.
Laboratory confirmatory tests:
- Serum
beta Hcg/quantitative blood tests
This is the most sensitive test for pregnancy and detects the hormone even at
earlier levels.
- Urine
tests
This test is also based on the increased levels of HCG but less sensitive when
compared to blood tests.
- Sonography-ultrasound scan can also be
used for diagnosing pregnancy. Gestational sac can be visualized as early
as four and half weeks of gestation (2˝ weeks after ovulation).It is not
necessary if the periods are regular and LMP (last menstrual period) is
known. It is necessary if:
Bleeding after missing a period.
To ensure if the growth is proper.
To rule out ectopic pregnancy.
False positives and negatives:
False positives:
In
home pregnancy tests, there appear evaporation lines if the test is read after
the specified reaction time independent of actual pregnancy.
Women
treated with HCG injection as part of infertility treatment, test positive
irrespective of actual pregnancy.
Some diseases like choriocarcinomas, IgA deficiencies, heterophilic antibodies,
and even lung cancer also show elevated levels of HCG, giving false positive
results.
False negatives:
The most common reasons for false negative result is when the
testing is done very early.Quantative urine tests and the most sensitive urine
tests can detect pregnancy as early as 6-12 days after implantation. but the
less sensitive home pregnancy tests require adequately elevated levels of
hormone to detect it.Menstrution occurs after 14 days of ovulation and the
likelihood of false negatives decreases once a menstrual period is late.
The accuracy of pregnancy tests is related to the day
of ovulation not the day of intercourse.Because it is normal for the sperm to
be waiting in the fallopian tube for 5 days. Once the egg is released fusion
takes place leading to the formation of zygote. But it will take another 12
days for it to get implanted. Thus after implantation only there will be rise
in HCG levels. Thus it takes approximately 17 days after intercourse .Any tests
taken before this period will give negative results. Moreover it takes a few more
days to reach adequate levels to be detected by less sensitive pregnancy tests.
Other prenatal tests:
The various tests that are routinely done during pregnancy
include:
- Blood
group detection.
To identify the blood group and Rh factors to prevent complications
later.
- Blood
tests for AIDS, hepatitis, rubella, VDRL
Elisa tests is carried on to rule out any sexually
transmitted diseases, specific blood tests to find out HbA2 (Thalassemia
carriers ),HBsAg (hepatitis B carriers.).VDRL to diagnose syphilis.
- Ultrasound/sonography
to check for foetal heart beat and any abnormalities in foetal
development.other conditions like spina-bifida and placental abnormalities
can also be identified at an earlier stage.
· Urine
test for albumin.
Other tests may be required in special circumstances,
particularly in high risk pregnancies. These include :
- Alpha-foetal
protein (AFP) takes the measure of particular fetoprotein levels in the
foetus and the mother’s blood to rule out any developmental abnormalities
of the foetus.
- Chorionic
villus sampling (CVS) takes the measure of chorion covering the baby to
detect any genetic abnormalities in the baby.
- Non-stress
tests done to detect the response of the foetus to any external sound and
tactile stimuli.
- Amniocentesis
done with the fluid carefully taken from the amnion of the baby tested for
any genetic abnormalities.
Viability tests:
Many pregnancy tests are used to study the viability of the pregnancy, series
of quantative blood tests are taken to measure the gradual changes in the blood
levels of HCG against a normal standard levels. Any abnormalities denote
increased chances of miscarriages and ectopic pregnancy.
Ultrasound can also be used for this purpose. The growth of the foetus is
visually seen at regular intervals .Any abnormalities can be easily detected
from the scan.