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Journal of Veterinary Diagnostic... May 2016The objective of our study was to evaluate 2 pregnancy-associated glycoprotein (PAG)-based enzyme-linked immunosorbent assays (ELISAs) for use with either blood or milk....
The objective of our study was to evaluate 2 pregnancy-associated glycoprotein (PAG)-based enzyme-linked immunosorbent assays (ELISAs) for use with either blood or milk. From 12 dairy farms, 116 Montbéliarde or Holstein cows were selected that had either undergone artificial insemination (AI; n = 102) or had calved (n = 14) 2-3 months earlier and had not undergone any further AI. Serum, plasma, and milk were obtained from all cows; serum and plasma were analyzed using the blood pregnancy test and milk using the milk pregnancy test. No false-positive results were observed when samples of the 14 noninseminated cows were tested. Cows undergoing AI were sampled at ~16, 30, and 41 days post-AI. An additional milk sample was taken at ~53 days post-AI. To establish whether the inseminated cows were pregnant, the cows were subjected to transrectal ultrasonography (TU) on or around day 41. Of the 102 inseminated cows, 63 were confirmed pregnant by TU. By day 30, the serum, plasma, and milk ELISAs demonstrated 100%, 100%, and 98.1% sensitivity and 88.6%, 88.9%, and 90.3% specificity, respectively, with potential pregnancy losses 30-41 days post-AI. Accuracy obtained on serum, plasma, and milk at ~41 days post-AI and on milk at ~53 days post-AI ranged from 97.4% to 100%. There were no differences of practical significance in performance between the blood and milk ELISAs for the sampling dates chosen. This new diagnostic capability with milk samples offers a major improvement in bovine reproductive management.
Topics: Animals; Cattle; Dairying; Enzyme-Linked Immunosorbent Assay; Female; Milk; Predictive Value of Tests; Pregnancy; Pregnancy Tests; Pregnancy-Specific beta 1-Glycoproteins
PubMed: 26944877
DOI: 10.1177/1040638716632815 -
Contraception Oct 2002
Topics: Amenorrhea; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Contraindications; Developing Countries; False Positive Reactions; Female; Humans; Postpartum Period; Pregnancy; Pregnancy Tests; Safe Sex
PubMed: 12413628
DOI: 10.1016/s0010-7824(02)00363-3 -
Clinical Chemistry Aug 1990
Topics: False Positive Reactions; Female; Humans; Pregnancy Tests; Reagent Kits, Diagnostic
PubMed: 2387054
DOI: No ID Found -
The American Journal of Emergency... Oct 2022
Topics: Emergency Service, Hospital; Female; Humans; Pregnancy; Pregnancy Tests; Radiography; Triage
PubMed: 35710540
DOI: 10.1016/j.ajem.2022.06.020 -
Journal of Dairy Science Sep 2016Chemical pregnancy testing is an alternative to traditional methods of pregnancy diagnosis (either manual palpation or ultrasound) in postpartum dairy cows and heifers....
Chemical pregnancy testing is an alternative to traditional methods of pregnancy diagnosis (either manual palpation or ultrasound) in postpartum dairy cows and heifers. The objective was to validate a chemical pregnancy test that confers the advantages of using whole blood, rapid incubation times, and visual readout. Blood and milk samples were collected from Holstein dairy cows [n=320; 162±62 (mean ± SD) d in milk] on a confinement farm in northeast Missouri at 28 d after artificial insemination (AI). The samples were assayed for pregnancy-associated glycoproteins (PAG) by using a rapid visual test as well as traditional plasma- and milk-based tests. Transrectal ultrasonography diagnosis for pregnancy at 35 to 38 d after AI was the reference (gold) standard for all PAG tests. One hundred fifty-nine cows were diagnosed as pregnant by the reference standard (pregnancies per AI=49.7%). The tests were ELISA and either optical density (OD; measured with a microtiter plate reader; plasma, milk, and rapid visual tests) or visual readout (rapid visual test) were used to diagnose pregnancy. When OD was used, the percentage of pregnant cows classified correctly (sensitivity) for the plasma, milk, and rapid visual tests were 97±1, 96±2, and 95±1% (±SE), respectively. The sensitivity of the rapid visual test when assessed visually was 98±1%. The specificity (proportion of nonpregnant cows classified correctly) for the plasma, milk, and rapid visual was 94±2%, 94±2%, and 93±2% when an OD was used. When read visually, the specificity of the rapid visual test was lesser (85±3%) because some cows with faint visual signals yielded false positive diagnosis. The overall accuracy (proportion of pregnant and nonpregnant cows diagnosed correctly) was similar for all tests (plasma, milk, rapid visual OD, and rapid visual; 96±1, 95±1, 94±1, and 92±2%, respectively). In a second experiment, lactating Holstein cows (n=291) from 4 commercial confinement dairy farms in western Kentucky were tested 25 to 95 d after AI using the rapid visual test. The OD of the rapid visual test followed the known profile for PAG in circulation during the first trimester of pregnancy. The conclusion is that the rapid visual test has equal sensitivity and accuracy as existing PAG tests. A slightly lower specificity was found when the rapid visual test was read visually.
Topics: Animals; Blood Chemical Analysis; Cattle; Dairying; Enzyme-Linked Immunosorbent Assay; Female; Glycoproteins; Kentucky; Lactation; Milk; Missouri; Pregnancy; Pregnancy Proteins; Pregnancy Tests; Sensitivity and Specificity; Time Factors
PubMed: 27394956
DOI: 10.3168/jds.2016-11224 -
Contraception May 2013Safe initiation of contraceptive methods requires that pregnancy be excluded. The World Health Organization has developed a list of criteria to assess pregnancy status.... (Review)
Review
BACKGROUND
Safe initiation of contraceptive methods requires that pregnancy be excluded. The World Health Organization has developed a list of criteria to assess pregnancy status. This review was conducted to evaluate the evidence regarding these criteria in excluding pregnancy.
STUDY DESIGN
The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning the performance of a pregnancy checklist compared to urine pregnancy tests. The quality of each study was assessed using the United States Preventive Services Task Force grading system.
RESULTS
Four analyses of data from three studies met inclusion criteria as direct evidence. All were diagnostic accuracy studies of fair quality that evaluated the performance of a pregnancy checklist compared with urine pregnancy test to rule out pregnancy. The performance of the checklist varied, with sensitivity ranging from 55-100% and specificity ranging from 39-89%. The negative predictive value was consistent across studies at 99-100%.
CONCLUSION
All four analyses demonstrated high (99-100%) negative predictive value for the pregnancy checklist.
Topics: Checklist; Contraception; Female; Humans; Pregnancy; Pregnancy Tests
PubMed: 23040127
DOI: 10.1016/j.contraception.2012.08.007 -
Pediatric Clinics of North America Jun 1989Pregnancy testing and counseling are increasingly accepted as necessary services for adolescents within the primary care setting. For teenagers in need of a pregnancy... (Comparative Study)
Comparative Study Review
Pregnancy testing and counseling are increasingly accepted as necessary services for adolescents within the primary care setting. For teenagers in need of a pregnancy test, the easy-to-perform, highly sensitive and specific enzyme immunoassay analysis for measuring beta-human chorionic gonadotropin (beta-HCG) is ideal. However, no single beta-HCG analysis should be taken as absolute evidence for the presence or absence of pregnancy. Instead, an integrated approach using all of the health care professional's skills in adolescent health care should be taken. In some cases a careful history and physical examination will confirm the pregnancy. At other times serial quantitative serum HCG titers, pelvic ultrasonography, and culdocentesis may be necessary to rule out the possibility of ectopic pregnancy or threatened abortion. For more than three quarters of pregnant adolescents the pregnancy is unplanned and may represent a major conflict for themselves, their partner, and their families. When such an event occurs the health care professional will frequently be sought as a resource. Successful pregnancy counseling has many components. The adolescent will need to visualize the counselor as an available, sensitive, nonjudgmental individual who believes in the right of the pregnant teenager ultimately to progress to her own decision. The counseling process should be firmly based on an understanding of adolescent psychosocial and biologic development, crises intervention techniques, and family dynamics. The counselor needs to be a reliable information source. If the adolescent decides to go to term, programs offering comprehensive prenatal services to teenagers should be identified. Information concerning high-quality, low-cost abortion services also will need to be available for those who wish to terminate. It is important to monitor the quality of care given in prenatal and abortion service referrals. Few adolescents currently choose to place their babies for adoption. Counseling in this area is especially needed. Several types of adoption procedures are available and at appropriate times during a teenager's neonatal care adoption should be presented as a reasonable alternative to parenthood. Throughout this process, the health care professional will have opportunities to discuss a wide variety of health related topics with the adolescent and often her partner and their respective families. Ideally, whatever her final decision, it is the goal of the counselor to make the experience a positive and maturing influence on her life and the lives of other persons involved.
Topics: Abortion, Induced; Adolescent; Adoption; Counseling; Female; Humans; Jurisprudence; Pregnancy; Pregnancy Tests; Pregnancy Tests, Immunologic; Pregnancy in Adolescence; Reagent Kits, Diagnostic; United States
PubMed: 2660091
DOI: 10.1016/s0031-3955(16)36691-3 -
Anais Brasileiros de Ginecologia Feb 1964
Review
Topics: Antigen-Antibody Reactions; Chorion; Chorionic Gonadotropin; Female; Gonadotropins; Humans; Pregnancy; Pregnancy Tests
PubMed: 14135031
DOI: No ID Found -
Contraception Sep 2021To evaluate individuals' ability to perform and comprehend low-sensitivity and multilevel urine pregnancy tests during medication abortion follow-up. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To evaluate individuals' ability to perform and comprehend low-sensitivity and multilevel urine pregnancy tests during medication abortion follow-up.
STUDY DESIGN
We conducted a pilot study of individuals using mifepristone and misoprostol for medication abortion through 63-days gestation. We randomly assigned participants to use a 1000 mIU/mL low-sensitivity pregnancy test or a five-level multilevel pregnancy test. Seven days after mifepristone, participants performed their test and completed a questionnaire. One week later, participants performed another test if day 7 low-sensitivity test had been positive or day 7 multilevel test had not shown a one-level drop. We assessed comprehension of abortion status based on participants' final test interpretation, and defined correct comprehension when patient report of pregnancy status was consistent with pregnancy test result. We also assessed usability with a 100-mm Visual Analogue Scale (0 'very easy'; 100 'very difficult') and satisfaction.
RESULTS
We enrolled and randomized 88 participants to low-sensitivity (n = 43) and multilevel (n = 45) test groups. Comprehension was correct in 38/39 (97%) and 41/45 (91%) of low-sensitivity and multilevel test users, respectively (p = 0.37). When the test indicated a possible ongoing pregnancy, all three low-sensitivity test users and two of three multilevel test users accurately comprehended their results. Participants rated ease of use as 7.5 (range 0-68) for low-sensitivity and 9.0 (range 0-52) for multilevel (p = 0.24) tests. Most participants were likely or very likely to recommend use of their test (32/36 [89%] low-sensitivity and 42/44 [95%] multilevel test users, p = 0.66).
CONCLUSIONS
Patients could comprehend and use low-sensitivity and multilevel tests during medication abortion follow-up with similar satisfaction.
IMPLICATIONS
Individuals are able to independently use both the low-sensitivity and multilevel tests for medication abortion follow-up. Both are acceptable for medication abortion follow-up without in-person contact, but future, larger studies to compare comprehension of both tests may be necessary.
Topics: Abortion, Induced; Female; Humans; Mifepristone; Misoprostol; Pilot Projects; Pregnancy; Pregnancy Tests
PubMed: 33992610
DOI: 10.1016/j.contraception.2021.05.003 -
Contraception Jan 2016To improve access to contraceptives in remote and rural areas, sub-Saharan African countries are allowing community health workers (CHWs) to distribute hormonal... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To improve access to contraceptives in remote and rural areas, sub-Saharan African countries are allowing community health workers (CHWs) to distribute hormonal contraceptives. Before offering hormonal contraceptives, CHWs must determine pregnancy status but often lack a reliable way to do so. No studies have evaluated the impact of providing CHWs with urine pregnancy test kits. We assessed the impact of giving CHWs free pregnancy test kits on the number of new clients purchasing hormonal contraceptives from CHWs.
STUDY DESIGN
We implemented a randomized experiment in Eastern Madagascar among CHWs who sell injectable and oral hormonal contraceptives. A total of 622 CHWs were stratified by region and randomly assigned at the individual level. Treatment-group CHWs were given free pregnancy tests to distribute (n analyzed=272) and control-group CHWs did not receive the tests (n analyzed=263). We estimated an ordinary least-squares regression model, with the monthly number of new hormonal contraceptive clients per CHW as our primary outcome.
RESULTS
We find that providing CHWs with free pregnancy test kits increases the number of new hormonal contraceptive clients. Treatment-group CHWs provide hormonal contraceptives to 3.1 new clients per month, compared to 2.5 in the control group. This difference of 0.7 clients per month (95% confidence interval 0.13-1.18; p=.014) represents a 26% increase.
CONCLUSIONS
Giving CHWs free pregnancy tests is an effective way to increase distribution of hormonal contraceptives. As pregnancy tests become increasingly affordable for health-care systems in developing countries, community-based distribution programs should consider including the tests as a low-cost addition to CHWs' services.
IMPLICATIONS
No study has evaluated the impact of giving CHWs free urine pregnancy test kits for distribution to improve provision of hormonal contraceptives. Giving CHWs free pregnancy test kits significantly increases the number of clients to whom they sell hormonal contraceptives. Community-based distribution programs should consider including these tests among CHWs' services.
Topics: Adult; Community Health Services; Community Health Workers; Contraceptive Agents, Female; Contraceptives, Oral, Hormonal; Developing Countries; Female; Humans; Injections; Madagascar; Middle Aged; Pregnancy Tests; Program Evaluation; Rural Health Services
PubMed: 26409247
DOI: 10.1016/j.contraception.2015.09.011