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Pregnancy Testing

Definition

Urine or blood tests used to detect whether a woman is pregnant.
 
Description

The earliest way to know for sure whether you are pregnant is to have a pregnancy test. The fertilized egg at about 4 days old begins to secrete a hormone called human chorionic gonadotropin (HCG). Initially, it can be detected in the mother's blood, and shortly thereafter it is detected in the mother's urine.

Human chorionic gonadotropin is not found in the urine of non-pregnant women. Immunologic pregnancy tests employ antibodies to detect HCG in urine and blood.

Increased urinary levels of HCG form the basis of most tests for pregnancy and trophoblastic tumors in men. HCG is present in both blood and urine whenever there is living chorionic/placental tissue.

HCG can be further identified as alpha or beta HCG. It can be detected in the urine of pregnant women 26 to 36 days after the first day of the last menstrual period, or 8 to 10 days after conception.

Most pregnancy tests are conducted with a sample of urine, which is obtained more easily than a sample of blood. Most depend on a reaction between HCG and an antibody to HCG. A second reaction is then needed to determine whether the first reaction has taken place. Often that is a color change.

About three-fourths of the time, results of a urine test done in a clinic or a physician's office will be positive if you are pregnant and your period is 4 to 7 days late. When your period is 2 weeks late, the accuracy is close to 100 percent.

The recently developed enzyme-linked immunosorbent assay (ELISA) for HCG allows quick and easy determination of the presence of even small quantities of the hormone in the urine.

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Use of Blood Tests

Urine pregnancy tests are the most frequently used, but in some cases a blood test may be indicated because it is more accurate, can detect pregnancy earlier and is better in situations in which the urine specific gravity is not appropriate.

In the case of an ectopic pregnancy - in which the egg begins to grow in the fallopian tube or someplace other than the uterus - a woman may have all the signs of pregnancy, despite negative results of urine pregnancy tests. This occurs because urine HCG levels may not be high enough to be detected when the egg is not in the uterus. The blood test, however, is more sensitive and could detect the pregnancy.

Because ectopic pregnancy is a potentially life-threatening condition, this information could ultimately help save the mother's life.

Beta subunit HCG is an extremely sensitive blood test used to detect very early pregnancy. In this test, HCG is detectable in a woman's blood within 7 days after ovulation and implantation in the uterine wall, just at or before the time of a missed menstrual period.

The Beta subunit is a component of the HCG molecule that is specific only to HCG; other components of the HCG molecule are shared with other hormones, leading to occasional "false positives."

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Questions to Ask Your Doctor

Are home pregnancy tests accurate?

If the urine test is negative, will you perform a blood test?

How long will she have to wait for the results of the blood test?

If both tests are negative and there are still signs of pregnancy, how long before she should be re-tested?

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