Negative Pregnancy Test Results Research Articles

Serum Chemokines and Quality of Life among Patients with Endometriomas and Teratomas

Background: Endometriosis is a chronic inflammatory condition characterized by the presence of endometrial tissue outside the uterus, which can cause pelvic pain, infertility, and other symptoms. The disease may manifest as superficial peritoneal or deep-infiltrating endometriosis or as ovarian endometriomas. Although the mechanisms associated with the regulation and production of inflammatory mediators in endometriosis have been widely investigated, the precise mechanism responsible for inflammation-induced pain remains unclear, and the findings related to the cytokine expression profile and the location of cytokines in cells are contradictory. The intensity of pain experienced by endometriosis patients is not proportional to the degree and severity of their disease. Pain has a significant impact on women suffering from endometriosis. Methods: The following inclusion criteria to the study were: presence of endometriomas vs teratomas, negative pregnancy test result, no prior obstetric and infertility treatment, and good health condition with no diseases or coagulation disorders. Blood samples were collected from all patients. The serum levels of chemokines were determined by ELISA. The Nottingham Health Profile (NHP) questionnaire was made. Results: The median serum levels of chemokines: Monocyte Chemoattractant Protein 1 (MCP-1) and Monocyte Chemoattractant Protein 3 (MCP-3) were statistically higher in the endometriomas group compared to the other two groups. In the NHP questionnaire the comparison of the subjective health dimensions in individual groups showed that the patients in the endometriomas group experienced a significantly higher intensity of “PAIN” compared to other groups. Correlation analysis between NHP dimensions and serum chemokine levels: spearman’s rank correlation analysis indicated a statistically significant relationship between the “VITAL ENERGY” dimension and the level of MCP-2 (r = –0.295; p = 0.022), MCP-3 (r = 0.254; p = 0.050), and RANTES (r = –0.353; p = 0.006); between the “EMOTIONS” dimension and the level of MCP-3 (r = 0.262; p = 0.043); and between the “INCONVENIENCE IN DAILY LIFE” dimension and the level of Eotaxin-1 (r = –0.283; p = 0.028) and CCL13 (r = –0.287; p = 0.026). Conclusions: The chemokines serum levels (i.e., MCP-1 and MCP-3) and intensity of “PAIN” were statistically higher in the endometriomas compared to the teratomas group of women. Therefore, understanding their role in endometriosis-related pain could help in the development of novel, multidisciplinary treatments.

The value of a registry negative urine pregnancy test for the prediction of a future unintended pregnancy among young women

Background: Performance of urine pregnancy test in general adolescents’ clinic reflects caregiver or woman’s concern that there might be a pregnancy. We aimed to assess whether young-unmarried women in whom a negative urine pregnancy test was registered would be at increased risk of a future unintended pregnancy.Methods: The study cohort included consecutive women drafted by the Israeli military between 2013 and 2015. The risk of unintended pregnancy was compared between women with a negative urine pregnancy test (n = 2774), the study group, and those in whom urine pregnancy test was not carried out (n = 126,659), the control group.Results: During the study period, 2147 (1.7%) women experienced an unintended pregnancy. The risk of unintended pregnancy was significantly higher in patients in whom a past pregnancy test was negative 4.3% (n = 118), as compared with the control group 1.6% (n = 2028) (odds ratio [OR], 2.7; 95% confidence interval [CI], 2.23–3.26). In multivariate analysis history of a negative pregnancy test results was an independent predictor for a future unintended pregnancy (adjusted OR, 2.0; 95% CI, 1.63–2.52).Conclusions: A history of a negative pregnancy test among young conscripted women is a significant risk indicator for a future unintended pregnancy. Directed efforts should be made in this particular vulnerable group of patients.

The effect of cotinine concentrations in seminal plasma and follicular fluid on the pregnancy outcomes of couples undergoing assisted reproductive techniques.

This study determined the effects of cotinine concentrations in follicular fluid (FF) and seminal plasma (SP) on the pregnancy outcome of couples using assisted reproductive techniques (ARTs). This study was conducted as a case-control study. A total of 217 couples were included in the study. Among these couples, there were nonsmokers (66 women and 40 men), passive smokers (106 women and 54 men), and active smokers (45 women and 123 men). Demographic and smoking data were collected by questionnaire at the onset of treatment. FF and SP samples were obtained from the couples on the day of oocyte retrieval. The cotinine concentrations in the FF and SP of nonsmokers were significantly lower than they were in the other groups (P = 0.001). The difference in cotinine concentrations detected in FF between women with positive pregnancy test results and women with negative pregnancy test results was statistically insignificant. It was also determined that the percentage of clinical pregnancy was lower in nonsmoker women than in passive smoker or smoker women (P > 0.05). Although we found there was no significant difference in the pregnancy outcome between nonsmoker and passive smoker or smoker women, smoking cessation should be an integral part of ARTs.

Embarazo adolescente no diagnosticado: análisis de un evento centinela

A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.The sentinel event identified was undiagnosed adolescent pregnancy before the indication of potentially harmful treatments or diagnostic methods. The team performed a root -cause analysis where the following causes were identified: a) Paediatrician bias: not thinking about adolescent sexual behaviour, incomplete questionnaires, insufficient training in adolescent interviews. b) Social factors: legal issues, ambiguous contraceptive recommendations. c) Hospital factors: lack of guidelines for counselling adolescents. d) Host risk factors: cultural barriers, lack of confidence. Regardless of any previous negative pregnancy test results, any time that a new potentially harmful procedure is indicated in a fertile female patient, a test of pregnancy diagnosed might be performed.

Point-of-Care and Over-the-counter Qualitative Human Chorionic Gonadotropin (hCG) Devices Remain Susceptible to False-Negative Results Caused by Excess hCG β Core Fragment

To the Editor: Previously, we reported false-negative results generated by the OSOM human chorionic gonadotropin (hCG)1 Combo test (Genzyme Diagnostics) (1) and certain lots of the hCG Cardinal Health Combo SP brand rapid test device (SP hCG rapid test; Cardinal Health) (2) owing to increased concentrations of hCG β core fragment (hCGβcf). We refer to this phenomenon as the variant hook effect. In a hospital setting, these false negatives pose a substantial risk of adverse outcomes if pregnant patients are given treatments that can affect the fetus. This observation was reported to the US Food and Drug Administration, but to our knowledge no action has been taken to change these devices. These false negatives also pose considerable risk to women at home, because a negative pregnancy test result may cause delays in prenatal care and continued engagement in behavior that can endanger the fetus. In view of the variable sensitivity of point-of-care (POC) and over-the-counter (OTC) devices to intact and variant forms of hCG as documented in the previously mentioned studies and others (3, 4), we assessed the susceptibility of OTC devices to hCGβcf interference and compared the performance of the most susceptible OTC devices to the 2 …

Woman With Right-Sided Flank Pain

A 26-year-old woman presented to the emergency department with 2 weeks of intermittent right-sided flank pain, nausea, and vomiting. She reported several days of hematuria but denied dysuria, fever, or chills. Vital signs were unremarkable, and physical examination demonstrated moderate right costovertebral angle tenderness. Urine studies showed RBCs and WBCs too numerous to count, few bacteria, and a negative pregnancy test result. After emergency ultrasonography was performed (Figures 1 to 3), a urology consultation and computed tomography (CT) of the abdomen and pelvis were obtained (Figure 4).

Hemoglobin levels predict quality of life in women with heavy menstrual bleeding

This study was designed to evaluate the effects of heavy menstrual bleeding (HMB) on the quality of life (QoL). A prospective, observational study was conducted including 58 patients with HMB, aged 35 years or older, with a negative pregnancy test result, menstrual blood loss >80 ml, uterine volume up to 200 cc and negative endometrial biopsy. The QoL was evaluated by interview using the Short Form-36 (SF-36) questionnaire. Blood loss, measured by Pictorial Blood Loss Assessment Chart (PBAC), and hemoglobin levels were also assessed. Statistical analysis was performed using the Pearson coefficient correlation test. The age of the patients ranged from 35 to 52 years (42.8+/-0.2 years). Increase in monthly expenses, negative implications in conjugal life, work impairment and health-care utilization due to HMB were seen in 96.5, 94.7, 66.7 and 59.6% of the patients, respectively. Hemoglobin levels correlated to SF-36 physical and mental composites scores (p=0.020 and p=0.027, respectively). PBAC score was not correlated with the QoL (physical composite score: p=0.222 and mental composite score: p=0.642) or with hemoglobin levels (r=-0.065; p=0.278). Hemoglobin and QoL showed significant improvement after treatment (p<0.001). Hemoglobin level was the only independent predictor of the QoL measured by SF-36 physical (p=0.03) and mental (p=0.04) composites scores. HMB had significant repercussions in the social, medical and economic aspects of women. The impact on the QoL was associated with the hematimetric parameters.

Human albumin does not prevent ovarian hyperstimulation syndrome in assisted reproductive technology program: a prospective randomized placebo-controlled double blind study

We aimed to clarify the efficiency of IV human albumin in the prevention of ovarian hyperstimulation syndrome (OHSS). We found that human albumin at the described strength does not seem to either prevent or reduce the incidence of severe OHSS in high risk patients undergoing intracytoplasmic sperm injection (ICSI).

Reproductive care and rates of pregnancy in teenagers with negative pregnancy test results

Purpose The purpose of this study was to follow-up adolescent girls with negative pregnancy tests (NPTs) through an 18-month follow-up analysis of health services received, patterns of contraception use, and pregnancy outcomes. Method This study involved a retrospective review of medical records of 129 adolescent patients who had a NPT result from clinical sites in an urban medical center during a 3-month period in 1997. A stratified random sample of participants was selected from adolescents who received care at 2 school-based health centers, a women’s health center, and an adolescent health clinic associated with a large academic medical center. Findings Analysis of the 129 cases indicated that the cohort of adolescents with NPTs appears to be a higher risk group of girls than suggested by previous studies. Of the multi-ethnic sample with a mean age of 16.2 ± 1.4 years at the time of the NPT, 47% had already had 1 or more pregnancies and 25% had 1 child. Thirty percent of the subjects were offered condoms, and 50% were offered hormonal contraception at the time of the NPT; only 46% were given a return appointment. By 18 months after the index pregnancy test, 36% of the subjects had 1 or more pregnancies, and the majority of the subjects had used no form of contraception or had used contraception inconsistently. Conclusions Comprehensive reproductive health services often are not offered to adolescents who receive NPT results. Sexually active teenagers need thorough reproductive care and consistent follow-up evaluation to avoid sexually transmitted infections (STIs) and unintended pregnancies.

Adolescent Girls with Negative Pregnancy Tests

Study Objectives and Design This descriptive study assessed background characteristics and attitudes about pregnancy held by adolescent girls presenting for pregnancy tests and receiving negative results. An additional aim was to determine types of health care services that would be of perceived benefit to them to reduce their risk of subsequent pregnancy. Setting Two health care sites in an urban community included a hospital-based adolescent clinic and a hospital-based women's health care clinic. Participants Sixty-five adolescent, low-income, single women with negative pregnancy test results in a consecutive sample were included in the study. Participants had a mean age of 16.9 (±1.3) years and described themselves as 64.1% African American, 26.6% Latina and 9.4% white, with 81.5% enrolled or recently graduated from high school. Main Outcome Measures The following variables were included: demographic characteristics, reproductive health history, personal and perceived partner attitude about the negative pregnancy test result, perceived parental influences, and teens' suggestions for health care services to prevent unintended pregnancy. Results Health history data revealed high risk status for unintended pregnancy and sexually transmitted infections (STI); 28.5% of participants were ambivalent or disappointed with their negative result, 71.4% were pleased and the majority felt that their partners would be more disappointed with the negative result than they were. Health care services that teens felt would be most helpful were one-on-one contraceptive education and discussion sessions with their own health care provider. Conclusions Sexually active teen women with negative pregnancy test results are at high risk of subsequent pregnancy and STIs, and present important opportunities for preventive reproductive health care during visits with health care providers.

Clinicians' views on reproductive needs and services for teens with negative pregnancy tests.

To explore services available to adolescent girls at the time of the negative pregnancy test (NPT) in an urban community. Clinician focus groups were conducted to identify the needs of adolescents at the time of a NPT result. Teens access care in a variety of ways, services provided at the time of a NPT were agency and clinician dependent, and strategies for follow-up care often were unstructured. Few services were available for parents or partners. Barriers included difficulty communicating with agencies, lack of staff trained to work with adolescents, and time/financial constraints. Adolescents need comprehensive, teen-friendly reproductive care at the time of a NPT result.

Prevalence of home pregnancy testing among adolescents

This study estimated the prevalence of home pregnancy testing among adolescents. A survey was administered in 11 urban clinics to 600 females aged 13 to 19 years. The prevalence of home pregnancy test use was 34% among 474 sexually experienced youths; 77% of the users had received at least 1 negative pregnancy test result, and 48% took no further action for confirmation. Compared with those who had never used such tests, users were older, younger at sexual debut, less likely to consistently use effective birth control, and more likely to have ever been pregnant. Health care clinics are important sources for pregnancy prevention, but clinics may have limited opportunity to intervene with some youths who use home pregnancy tests.

FDA's role in anesthetic drug development.

FDA's role in anesthetic drug development.

Focusing on the pregnancy test

Due to high abortion rates in a low status area in Göteborg, Sweden, a study was performed focused on the pregnancy test.The aim of the study was to facilitate the accessibility of contraceptive counseling offering immediate and extended family planning advice to women with negative pregnancy tests not wishing to become pregnant. There was also an ambition to better understand the lack or inconsistent use of contraceptives and decrease the rate of unwanted pregnancies, which could have an impact on the abortion rates.In an area with 5,200 women of fertile age immediate and extended family planning advice was offered by midwives to all women with no desire for pregnancy and negative pregnancy test results. During the six month data collection period in 1988-1989, 463 women received such a consultation, of whom 310 did not use any contraceptives at the time of the study. Several reasons, on different explanatory levels, for not using contraception were recognized.The abortion rate declined in the area, and this decline was observed two years earlier than for the rest of Göteborg. This decline, together with the information on contraception behavior received, may indicate that this kind of approach could be successful.

Adolescents With Negative Pregnancy Test Results

Objective. —To estimate nationally what percentage of young women receive negative pregnancy test results before becoming pregnant, to explore their fertility and test histories, and to estimate the potential for intervention at the time of a negative test result. Design. —A cross-sectional study in which young women presenting to clinics for pregnancy tests were asked to complete a self-administered questionnaire before test results were known that explored prior pregnancy tests, pregnancies, sexual and contraceptive histories, and childbearing attitudes. Setting. —Fifty-two clinics including hospital, health department, Planned Parenthood, and independent facilities. Participants. —A total of 2926 patients aged 17 years or younger requesting pregnancy tests at presentation. Results. —Among young women who had ever conceived, 34.2% had a prior negative pregnancy test result and 24.4% had a prior negative test result at a clinic. Almost three of five of the adolescent girls, including both those who had and those who had not conceived, received a negative test result at a clinic before they ever became pregnant. By the age of 14 years, the probability of a negative test result was substantially greater than the chance of a positive test. Many presented for tests even though they were quite certain that they were not pregnant. Conclusions. —Adolescent girls with a negative pregnancy test result may be an appropriate target group for intervention. One fourth of adolescent girls who have a negative pregnancy test may be identified by the health care system on that occasion in time to prevent early childbearing. ( JAMA . 1996;275:113-117)

Adolescents With Negative Pregnancy Test Results

To estimate nationally what percentage of young women receive negative pregnancy test results before becoming pregnant, to explore their fertility and test histories, and to estimate the potential for intervention at the time of a negative test result. A cross-sectional study in which young women presenting to clinics for pregnancy tests were asked to complete a self-administered questionnaire before test results were known that explored prior pregnancy tests, pregnancies, sexual and contraceptive histories, and childbearing attitudes. Fifty-two clinics including hospital, health department, Planned Parenthood, and independent facilities. A total of 2926 patients aged 17 years or younger requesting pregnancy tests at presentation. Among young women who had ever conceived, 34.2% had a prior negative pregnancy test result and 24.4% had a prior negative test result at a clinic. Almost three of five of the adolescent girls, including both those who had and those who had not conceived, received a negative test result at a clinic before they ever became pregnant. By the age of 14 years, the probability of a negative test result was substantially greater than the chance of a positive test. Many presented for tests even though they were quite certain that they were not pregnant. Adolescent girls with a negative pregnancy test result may be an appropriate target group for intervention. One fourth of adolescent girls who have a negative pregnancy test may be identified by the health care system on that occasion in time to prevent early childbearing.

Adolescents with negative pregnancy test results. An accessible at-risk group

Adolescents with negative pregnancy test results. An accessible at-risk group