Accuracy of home pregnancy tests at the time of missed menses

Cole, Laurence A.; Khanlian, Sarah A.; Sutton, Jaime M.; Davies, Suzy; Rayburn, William F.

doi:10.1016/j.ajog.2003.08.043

Cited by 65 publications

(32 citation statements)

References 8 publications

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“…The home pregnancy test (HPT), since its introduction in 1960, has revolutionized the way in which early pregnancy is diagnosed (1,55,56). The HPT contain antibodies that bind to the b-hCG molecule to form complexes that result in a color change, which the patient can easily see and compare to a control bar (1,55).…”

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

“…The HPT contain antibodies that bind to the b-hCG molecule to form complexes that result in a color change, which the patient can easily see and compare to a control bar (1,55). A clear correlation exists between blood and first morning urine levels of intact bhCG (57).…”

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

“…The FDA as well as the US Department of Health and Human Services has issued detailed quality guidelines, including sensitivity ranges, that must be followed by manufacturers of home urinary b-hCG tests (56,58,59). Tests routinely claim to have an accuracy of 99% to detect certain b-hCG concentrations, typically quoted at 25-100 mIU/mL (1,31,55).…”

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

“…Of 18 HPT brands tested in a 2003 trial, only one brand, the FIRST RESPONSE Early Results Pregnancy Test (Church & Dwight Co., Princeton, NJ), was able to detect a b-hCG level in this range (55). Another study found the FIRST RESPONSE Early Result Pregnancy Test (Church & Dwight Co.) could detect b-hCG concentrations of 6.3 mIU/mL (60).…”

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

See 3 more Smart Citations

At home testing: optimizing management for the infertility physician

Brezina

Haberl

Wallach

2011

Fertility and Sterility

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Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

Section: Pregnancy Urinary B-hcgmentioning

confidence: 99%

See 2 more Smart Citations

At home testing: optimizing management for the infertility physician

Brezina

Haberl

Wallach

2011

Fertility and Sterility

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“…Urine pregnancy test kits are widely available and relatively inexpensive. However, they have a high rate of false-negative results when used before the date of missed menses (15,16) and hence may fail to identify a pregnant patient if the test is performed too early. Serum hCG tests are able to detect smaller concentrations of hCG than urine tests (17) and therefore are more accurate when used before the date of missed menses.…”

Section: Discussionmentioning

confidence: 99%

Determining the Pregnancy Status of Patients Before Diagnostic Nuclear Medicine Procedures: The Australian Experience

James

Cardew²,

Warren‐Forward³

2011

Journal of Nuclear Medicine Technology

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Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients. Methods: Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded. Results: Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation. Conclusion: This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.

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A rare cause of abdominal pain in early pregnancy

Matiluko

Smith

2010

Trends Urology, Gynecol. Sexual Health

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twisted, necrotic left tube and ovary were found ( Figure 1). A laparoscopic left salpingo-oophorectomy was performed. The histology report showed extensive haemorrhage and necrosis of the left ovary and fallopian tube, but no evi dence of trophoblastic tissue to suggest ectopic pregnancy.Subsequently, a pelvic ultrasound scan showed a viable intrauterine pregnancy equivalent to eight weeks' gestation. She had vaginal progesterone support for the rest of the fi rst trimester. Her 20-week anomaly scan was normal and she gave birth to a healthy baby girl, at 39 weeks of gestation, by caesarean section for breech presentation. DiscussionTorsion of an ovary and fallopian tube is rare in pregnancy and poses a considerable diagnostic challenge. 1,2 The prevalence of this condition has been estimated at 1 in 1800, 3 but we believe this to be an overestimation.In the case reported here, the pregnancy was initially unrecognised because of a false-negative pregnancy test kit. False-negative qualitative urine pregnancy tests are well documented. 4-8 Qualitative point-of-care and home pregnancy tests both have limitations and are not 100 per cent sensitive in detecting pregnancy. In one study, 5 only 44 per cent of 18 brands gave a clearly positive result at serum beta-human chorionic gonadotrophin (β-hCG) levels of 100mIU/ml. In other words, 56 per cent were falsely negative. In a woman of childbearing age with abdominal pain, we therefore suggest that a negative qualitative urine pregnancy test should be confi rmed by quantitative serum β-hCG measurement.Laparoscopic salpingo-oophorectomy was performed because the tissues appeared necrotic and persistent fever suggested early sepsis. The necrosis was subsequently confi rmed histologically. However, successful detorsion of twisted adnexa has been described regardless of delay in diagnosis and the appearance of the adnexum. 1 A 33-year-old woman was referred to the urology team with a four-day history of left loin pain, syncope and vomiting. She had tachycardia (108 beats per minute), a mildly raised temperature (37.3°C) and tenderness in the left lumbar region and iliac fossa. Urine pregnancy test was negative, but a trace of haemolysed blood was found on ward urinalysis. An intravenous urogram showed no ureteric obstruction. A diagnosis of pyelonephritis was made.However, her pain failed to settle on antibiotics, and a gynaecological opinion was sought two days after admission. On questioning, her last menstrual period transpired to be three months before presentation. She was cardiovascularly stable, but examination revealed abdominal peritonism, a bulky uterus and cervical excitation. A repeat pregnancy test was positive. A clinical diagnosis of ectopic pregnancy was made.The authors present a case history of a pregnant woman with abdominal pain who was found to have torsion of an ovary and fallopian tube. This condition is rare in pregnancy and the case highlights the diagnostic challenges involved. Twisted adnexum Necrotic left tube Necrotic left ovary a b Figure 1. La...

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Accuracy of home pregnancy tests at the time of missed menses

Cited by 65 publications

References 8 publications

At home testing: optimizing management for the infertility physician

At home testing: optimizing management for the infertility physician

Determining the Pregnancy Status of Patients Before Diagnostic Nuclear Medicine Procedures: The Australian Experience

A rare cause of abdominal pain in early pregnancy

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