Urine Pregnancy Test Research Articles

Evaluation of methods for the prospective identification of early fetal losses in environmental epidemiology studies.

A major problem in the epidemiologic investigation of early fetal losses has been incomplete or biased ascertainment. In order to assess early fetal losses more accurately, one must first develop a simple method to identify early pregnancy. This study, conducted at the University of Pittsburgh from October 1985 through October 1986, has developed such a method through the use of monoclonal antibody urine pregnancy testing kits. A total of 88 volunteers collected urine samples beginning on the seventh postovulatory day and continued until either menses occurred or a serum radioimmunoassay pregnancy test was performed on day 16. If pregnancy was diagnosed, all of the participants' urine specimens from that menstrual cycle were analyzed by five monoclonal antibody tests. A total of 34 pregnancies were diagnosed, six (18%) of which resulted in early fetal losses. Pregnancy was first detectable between eight and 18 days postovulation. The mean time to the first positive test was 14 days for all five kits. The results indicate that it is possible to diagnose early pregnancy with urine testing and that this method is likely to prove acceptable for use in large-scale prospective studies.

Analytical versus clinical sensitivity and specificity in pregnancy testing

A typical urine pregnancy test with the enzyme-linked immunoassay for human chorionic gonadotropin (Tandem Icon human chorionic gonadotropin) was performed as was a qualitative serum radioimmunoassay for human chorionic gonadotropin when the positive cutoff for the latter was set at 30 IU/L. There was 99.5% concordance between the two methods when performed on 871 simultaneous urine and serum specimens. Although the serum radioimmunoassay can detect levels of human chorionic gonadotropin as low as 10 IU/L, in this study the majority of patients with serum levels between 10 and 30 IU/L were not pregnant on clinical follow-up. Of nine patients with adequate clinical follow-up, a negative urine pregnancy test result, and a serum human chorionic gonadotropin level between 10 and 30 IU/L, only one proved to be pregnant. The Tandem Icon human chorionic gonadotropin urine test is sufficient for routine pregnancy testing and to rule out the need for immediate intervention in cases of ectopic pregnancy

Testicular Neoplasm Diagnosed by Ultrasound

The diagnosis of testicular cancer is usually made by the findings of a testicular mass on physical examination. in rare cases a young man will present with retroperitoneal nodes and a normal testicular examination. in such cases a testicular ultrasound may localize the testis which harbors a subclinical neoplasm. in addition serum markers of B-HCG and AFP are essential. As a screening procedure a urine pregnancy test is helpful, since it can be obtained quickly while quantitative B-HCG and APF results are delayed.

Update on Pregnancy Testing

Laboratory testing is an extension of the physical examination, reaching sites that are otherwise inaccessible to the examiner. Pregnancy testing is one such diagnostic extension. Like physical examination, it must be used carefully. In choosing a pregnancy test for office use, many factors must be considered, so that accurate information will be available for patient management. Such factors as the technical skills and training of the office staff performing the test, shelf life of the test, need to refrigerate reagents, and frequency of usage are all important considerations. Test results must always be correlated with specific patients and clinical findings, and at times, doubts may be allayed by simply retesting patients with negative or equivocal results at a later time (currently a matter of days instead of weeks). Recent developments in pregnancy testing have been directed toward improved sensitivity and specificity, as well as speed, simplicity, and reduced cost. The clinical issue of greatest interest to most primary care physicians is the early diagnosis of normal pregnancy, where "early" may be defined as prior to the first missed menses. Diagnosis in the first 21 days of gestation is currently possible with more sensitive methods, and especially with enzyme-linked immunoassay. In this regard, because of its easy methodology and basic reliability, the enzyme-linked immunoassay may well become the new standard for office pregnancy testing.

Performance of a new enzyme-linked immunoassay urine pregnancy test for the detection of ectopic gestation

An enzyme-linked immunoassay urine pregnancy test was used on a group of patients suspected of having an ectopic pregnancy. Patients were seen in the county hospital emergency department and had the urine test correlated with a serum beta-hCG level determined by radioimmunoassay. There were 884 patients with urine ICON-serum beta-hCG correlations. The ICON was positive in each of the 247 patients whose serum value was over 50 mIU/mL, and was negative in each of the 619 patients whose serum level was below 5 mIU/mL. Eighteen patients had a serum level between 10 and 50 mIU/mL and the ICON was positive in 13. The five patients with a low serum beta-hCG level and a negative ICON had dilute urine when tested. Using a modified testing procedure, each of these produced a positive ICON. Of the 27 patients with an ectopic pregnancy the urine ICON was positive in 26. The urine ICON is an improved assay for hCG in patients suspected of having an ectopic pregnancy, and is ideally suited for ED use.

Female Genital Schistosomiasis Mimicking other Gynecologic Disease: Two Case Reports

Female Genital Schistosomiasis Mimicking other Gynecologic Disease: Two Case Reports

Ectopic pregnancy--an analysis of the etiology, diagnosis and treatment in 552 cases.

An analysis of the clinical data of 552 patients treated for ectopic pregnancy during 1973-82 in our hospital showed that the prevalence of this complication rose twofold (P less than 0.01) from an annual rate of 10.9 per thousand in 1973 to 20.9 per thousand in 1982. As regards parity distribution, the proportion of the 2-paras increased significantly (P less than 0.05) and this increase was significantly greater (P less than 0.001) than in the total population of parturients during this period. The increasing incidence of ectopic pregnancies had a significant positive correlation (P less than 0.05) with the use of an intrauterine device (IUD), but not with previous or present pelvic inflammatory disease or gynaecological or abdominal surgery. Because the 158 patients with an IUD in situ (34%) had a significantly less frequent past history of salpingitis, pelvic operation, infertility, ectopic pregnancy or spontaneous abortion and had less actual pelvic inflammatory changes than the 259 patients without contraception (57%), the IUD seemed to be directly involved with the increased risk of ectopic pregnancy. In the present study lower abdominal pain occurred in 97% of the patients and menstrual disorders in 93%; pelvic examination revealed adnexal mass in 63% and adnexal tenderness in 90% of the patients. Laparoscopy, a sensitive urinary pregnancy test (detection limit 75 IU/1) and culdocentesis were the most important factors in the diagnosis of ectopic pregnancy as evidenced by positive results in 97, 90 and 83% of the cases, respectively. Due to improved diagnostic procedures the annual rate of an unruptured tube at operation increased from 49% to 73% during the study period.

Evaluation of the new generation of urinary pregnancy tests

Five new enzyme-linked urinary pregnancy tests were compared with the older hemagglutination assay. Urine came from 60 patients with a simultaneous serum β-subunit of human chorionic gonadotropin determination. The new enzyme-linked kits have improved sensitivity with fewer false positive results than the older system. Some kits are clearly quicker and simpler to use than others.

Comparison of the performance of serum and urine hCG immunoassays in the evaluation of gynecologic patients

We conducted a study to compare the performance of serum and urine pregnancy tests in the evaluation of gynecologic patients presenting to our ED. The overall efficiency of the two tests was very similar: 99.5% for the serum test, and 97.6% for the urine test. In patients proven to have ectopic pregnancies, however, the serum test was positive in 100%; the urine test was positive in only 60%. The serum test misclassified (gave false-negative or false-positive results) in three of 607 patients (0.5%). The urine test misclassified 14 of 607 patients (2.3%). Moreover there were 18 inconclusive or invalid urine test results. Thus the urine test provided misinformation or no information in 32 of 607, or 5.3%, of the total study population.

A sensitive urine pregnancy test as an aid in the diagnosis of ectopic pregnancy

A highly sensitive 2-hour tube test for the detection of human chorionic gonadotropin (hCG) in urine was compared with the more resource-demanding radioimmunoassay for hCG in serum as an aid in the diagnosis of ectopic pregnancy. In a first series of 107 patients with the possibility of ectopic pregnancy, the urine test was positive in 31 patients, including all 15 patients shown to have an ectopic pregnancy. In a second series of 113 consecutive patients with ectopic pregnancy, the highly sensitive test was performed in 94 patients. It was positive in 90 (96%). The median time of amenorrhea at diagnosis was 7 weeks, and only 15 patients suffered a rupture of the fallopian tube. A highly sensitive urinary test for hCG is recommended as a screening method for patients giving even the smallest indication of ectopic pregnancy.

"Tandem ICON hCG" urine pregnancy test evaluated.

"Tandem ICON hCG" urine pregnancy test evaluated.

THE DISAPPEARANCE OF HUMAN CHORIONIC GONADOTROPIN FROM PLASMA AND URINE FOLLOWING INDUCED ABORTION

In 28 females, daily measurement of the HCG concentration in urine and in 15 of them daily measurement of the beta-HCG concentration in plasma was carried out during the first 2 weeks following first-trimester induced abortion by vacuum aspiration. Plasma beta-HCG concentration fell according to a multi-exponential curve with a half-life of 0.63 days in the first 2 days following induced abortion, and of 3.85 days in the subsequent 14 days. The disappearance of HCG from urine is exponential, with a half-life value of 1.3 days. A urine pregnancy test with a sensitivity of 1 IU/ml wil nearly always be negative in the course of 2 weeks after abortion. A positive test 4 weeks after abortion indicates an incomplete abortion or persistent trophoblast.

Detection of ectopic pregnancy in an outpatient population: The role of the beta-HCG level

A retrospective analysis was made of 265 female outpatients who initially presented to an emergency department with a complaint of amenorrhea, vaginal bleeding, or abdominal/pelvic pain. The patients were discharged from the emergency department pending results of a serum pregnancy test. Forty-five of the patients were subsequently found to have an elevated (>5 mIU/mL) beta human chorionic gonadotropin (HCG) level. Six of the patients had an ectopic pregnancy; their beta HCG levels ranged from 19 to 265 mIU/mL. A detectable beta HCG level less than 500 mIU/mL had a 33076 probability of an ectopic pregnancy in the study group. Historical features, physical examination, and laboratory parameters were of limited value for identification of minimally symptomatic outpatients at risk for an ectopic pregnancy. No study patient had a systolic blood pressure of less than 86 mm Hg on presentation. A comparison group of 29 patients admitted to the hospital directly from the emergency department with a diagnosis of “rule out ectopic pregnancy” during the same time interval was identified. Nine of the directly admitted patients were found to have ectopic pregnancies. A statistically greater proportion of the directly admitted patients had a hematocrit less than 35% and a positive urine (tube) pregnancy test than that found for the study group. Five of the comparison group patients were noted to have a systolic blood pressure of less than or equal to 80 mm Hg. The beta HCG was found to be an essential tool in the evaluation of potential ectopic pregnancy in patients with minimal symptomatology.

3 - Ectopic Pregnancy

Ectopic pregnancy remains a significant contributor to maternal mortality and morbidity. Despite the obstetrician's awareness of the problems, ectopic pregnancy in many cases still remains a difficult diagnosis. Over the last 10 to 15 years diagnostic ultrasound has become an established means of supplying additional and occasionally diagnostic information on those patients suspected of having an ectopic pregnancy. In essence diagnostic ultrasound can provide information regarding the presence of an intra-uterine pregnancy, a finding which goes a long way to excluding an extra-uterine pregnancy, and can show that there is no gestation sac within the uterus, a finding which raises the level of suspicion of an ectopic pregnancy. In addition to these primary uses, diagnostic ultrasound can also provide information relating to the presence or absence of both an adnexal mass and free fluid in the pouch of Douglas. All of these features, however, are open to error and their appreciation leads to a more rational approach to the interpretation of the overall ultrasound findings. In using diagnostic ultrasound in at-risk patients, side-room urinary pregnancy tests, and if necessary the more sophisticated radioimmunoassays of β-subunit hCG, should be used in conjunction. From the authors’ own studies it was concluded that an empty uterus with an adnexal mass and/or the presence of free fluid in the pelvis, together with positive biochemistry, was able to give a very high level of diagnostic accuracy for ectopic pregnancy (95 per cent). However, an empty uterus alone in the absence of an adnexal mass or free fluid in the pelvis was not of itself a reliable guide to the presence of an ectopic pregnancy even in the presence of positive biochemistry. The finding of a living fetus outside the uterus was an uncommon event (6 per cent), but if present allows an absolute diagnosis of ectopic pregnancy. Finally a negative serum hCG assay virtually excludes the possibility of an ectopic pregnancy. A scheme involving the use of urine pregnancy testing, serum hCG assays and ultrasound has been proposed for the rational management of patients suspected of having an ectopic pregnancy and whose condition is stable. In all circumstances, however, it is stressed that should the patient's condition so warrant then surgical intervention is mandatory irrespective of the ancillary findings.

"Tandem" urine pregnancy test evaluated.

Journal Article "Tandem" urine pregnancy test evaluated. Get access R T Tulley, R T Tulley Search for other works by this author on: Oxford Academic Google Scholar B B Thompson, B B Thompson Search for other works by this author on: Oxford Academic Google Scholar G M McCoy, G M McCoy Search for other works by this author on: Oxford Academic Google Scholar S G Parker S G Parker Search for other works by this author on: Oxford Academic Google Scholar Clinical Chemistry, Volume 29, Issue 12, 1 December 1983, Pages 2119–2120, https://doi.org/10.1093/clinchem/29.12.2119 Published: 01 December 1983

Five recent urinary tests for early pregnancy evaluated.

We evaluate five tests developed for the earlier detection of pregnancy, either in the clinical laboratory or by the patient in her home. These tests offer no advantage over other urinary pregnancy tests, and the results are distinctly inferior to those reported (Clin. Chem. 29: 561-563, 1983) for some serum tests for pregnancy.

Performances of Urine Pregnancy Tests on College of American Pathologists’ Survey Specimens

Pregnancy tests for human chorionic gonadotropins (hCG) in urine has yielded false-positive and false-negative results. The technical error rate in performing pregnancy tests is 1-4%. This paper presents the results of participant tests on the CAP (College of American Pathologists) Survey specimens. In 1979 and 1980 the CAP prepared 22 urine survey specimens for hCG testing. Radioimmunoassay was used to determine reference levels of hCG in these specimens. 8 negative specimens contained no hCG 8 low-level specimens contained 0.6-1.0 U/ml and 6 high-level specimens contained 2.2-3.8 U/ml. Laboratories participating in the CAP Urine Survey Program received and tested these specimens for the presence of hCG using their reagent products of choice and recorded their results as positive or negative. The CAP Computer Center tabulated the results as correct or incorrect according to the assayed levels of hCG within the specimens. 35014 hCG tests were performed. 58.9% were determined by slide procedures and 41.1% were determined by tube procedures. Correct results were obtained in 88.2-99.3% of participant tests. Correct results were obtained in 70.8-100% of participant tests on urine specimens containing high levels of hCG (2.2-3.8 U/ml) and in 2.2-96.4% of participant tests on urine specimens containing low levels of hCG (0.6-1.0 U/ml). This study shows that almost all the reagent methods used by participants performed well on the negative specimens. 2 major factors affect the performance of results with various urine pregnancy tests: 1) the sensitivity of the test for hCG detection and 2) the level of hCG in the specimen. Laboratory workers should develop a high level of awareness of the reagents sensitivity limitations and capabilities of commercial tests for urine hCG.

False-Positive Radioimmunoassay Pregnancy Test in Nephrotic Syndrome

THE TECHNIQUE of radioimmunoassay (RIA) is currently the most popular method for measurement of hormone levels in plasma or serum. Radioimmunoassay combines excellent sensitivity with precision and freedom from interference. However, subtle differences in RIA procedures can make a substantial difference in the reliability of this technique on serum or plasma samples from nephrotic patients. We report a case that shows repeated false elevations of β-human chorionic gonadotropin (β-HCG) levels during a period of nephrosis. Report of a Case A 17-year-old girl was seen because of gross edema of one to two weeks' duration. There was no history of renal disease or a recent known precipitating event. Her last menses had been approximately three months previously, and there had been at least one subsequent exposure to pregnancy. Urine pregnancy tests of unknown type done elsewhere during the previous week were said to be positive. Examination revealed generalized edema, with a

False-Positive Radioimmunoassay Pregnancy Test in Nephrotic Syndrome

THE TECHNIQUE of radioimmunoassay (RIA) is currently the most popular method for measurement of hormone levels in plasma or serum. Radioimmunoassay combines excellent sensitivity with precision and freedom from interference. However, subtle differences in RIA procedures can make a substantial difference in the reliability of this technique on serum or plasma samples from nephrotic patients. We report a case that shows repeated false elevations of β-human chorionic gonadotropin (β-HCG) levels during a period of nephrosis. Report of a Case A 17-year-old girl was seen because of gross edema of one to two weeks' duration. There was no history of renal disease or a recent known precipitating event. Her last menses had been approximately three months previously, and there had been at least one subsequent exposure to pregnancy. Urine pregnancy tests of unknown type done elsewhere during the previous week were said to be positive. Examination revealed generalized edema, with a

Urinary Immunoassay Pregnancy Test is Found Quick, Cheap, Accurate

Urinary Immunoassay Pregnancy Test is Found Quick, Cheap, Accurate