Saturday, 13 June 2020

Urine for pregnancy tests


Unlock the mystery of pregancy hormone
Q.1: What are the limitations of Urine for preg tests ? 
Most of the pregnancy   tests kits available in the market are intended  to test for the presence of a pregnancy by  looking  for the presence  of the beta   subunit  of hCG  or  human chorionic   gonadotropin in the blood  or  urine.
Q.2:- What is the chemical nature of hCG?? Ans: We  know that human  chorionic  gonadotropin is a glycoprotein  hormone secreted   by the  developing   placenta   shortly after   implantation  . hCG can be detected  in the urine   and serum of pregnant   women as early as 6-15 days after  conception. Q. 12 :    Why       Quantitative serum beta hCG   levels  estimation is superior to  UPT  .(Pregnancy  hCG  measurement  Tests)  : Advantages of Quantitative Tests :-
Qualitative blood tests generally   have a  threshold    of 25 mIU/mL and   are less   sensitive. However    quantitative  blood  tests can detect hCG levels  as low as 1 mIU/mL, while  urine tests  have published detection    thresholds   between 20  and 100 mIU/ml . Quantitative beta  hCG  readings   are also     used in evaluation of trophoblastic and other   germ cell tumors.
Quantitative serum beta hCG   levels are measured in mIU/mL  and a level above  25 mIU/mL   usually indicates    the presence  of a pregnancy .Two tests are usually necessary  to verify   a normal  increase usually  2-3  days   apart. The increase   in serum hCG can be interactively   monitored .
Q. 13:  What do we mean by Doubling time of hCG??      Doubling time varies:--Below   an hCG   level of 1,200  mIU/mL   the hCG  usually doubles every 48-72 hours, though   a rise  of 50-60 %    is still  considered  normal  . Between 1,200   and 6,000    mIU/mL   serum , The hCG   usually takes 72 -96  hours to double and above 6,000   mIU/mL   the hCG    often takes   more than   four days   to double. Failure to increase   normally   may indicate    that the pregnancy  is not developing   well and   can be an early sign  for a possible miscarriage   or an ectopic  pregnancy . After   a miscarriage.
HCG  levels  fall steadily back to  the non pregnancy  range   . Also   an ectopic   pregnancy  may be  suspected  when hCG   levels  fall  to double particularly if the HCG   level rises, fails and rises  again . Tips for performing hCG  :  if testing is entrusted  then  each your clinic  the “Need for patience in Pregnancy tests”
Since   pregnancy tests look for the hCG   hormone   which is produced    once the fertilized egg has  implanted   in the uterine   wall in most  cases, this happens  about  6 days after  conception. This has been duly mentioned couple of times.  But  studies  show  that in up to  10  percent of women , the embryo doesn’t  implant   until much  later , after  the first  day   of the missed  period. Hence   home pregnancy   tests will be  accurate as soon as one day after a missed  period for some women  but not for others. And because   the amount of hCG  in the urine  at different points  in early pregnancy   is different   for every woman Some woman  will have    accurate results   on the day of the missed period while others  will need to wait  longer. But   whatever   may be time period a positive   pregnancy test further    confirmed to be healthy by ultrasound techniques makes  all the hard work  and effort  of planning  pregnancy  worthwhile


Role of ultrasound   in pregnancy  detection
Once   a pregnancy has advanced   past the first   6-8  weeks the  pregnancy  is usually  easier to follow  by ultrasound  as   more   information is obtained   in real time. In general a pregancy is detectable 25 days after ovulation by   transvaginal   sonography   usually corresponding to an hCG  level of >1,500   miu/mL 



Q. 3: Can there be false +ve hCG?? Ans:-However, in rare cases, it may be produced by  a) choriocarcinoma   or some other  b)  germ cell tumours , or even  other forms   of cancer, e.g. c)  lung cancer.  If there is amenorrhoea and pt is in repro age group then one should keep these very rare possibilities in mind. Needless to mention that H mole also gelid +ve preg tests.

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