-
The Western Journal of Medicine Aug 2000
Review
Topics: Abortifacient Agents, Nonsteroidal; Chorionic Gonadotropin; Cost of Illness; Fallopian Tubes; Female; Fertility; Humans; Methotrexate; Pregnancy; Pregnancy Tests; Pregnancy, Ectopic; Risk Factors
PubMed: 10924442
DOI: 10.1136/ewjm.173.2.131 -
BMJ (Clinical Research Ed.) Apr 2000
Review
Topics: Abortifacient Agents, Nonsteroidal; Fallopian Tubes; Female; Fertility; Humans; Methotrexate; Pregnancy; Pregnancy Tests; Pregnancy, Ectopic; Risk Factors; Salpingostomy; Ultrasonography, Prenatal
PubMed: 10742003
DOI: 10.1136/bmj.320.7239.916 -
A Case of a False-Positive Urine Pregnancy Test and Delayed Diagnosis of Obstructive Pyelonephritis.The American Journal of Case Reports Mar 2020BACKGROUND Urine pregnancy tests are usually performed by women at home and also by healthcare professionals. However, there are several conditions that may cause a...
BACKGROUND Urine pregnancy tests are usually performed by women at home and also by healthcare professionals. However, there are several conditions that may cause a false-positive urine pregnancy test, including trophoblast tumors, malignancy, nephrotic syndrome, adenomyosis, tubo-ovarian abscess, and paraneoplastic syndromes. A case is presented of a false-positive urine pregnancy test in a 28-year-old woman with a history of tubal ligation, who had a delayed diagnosis of obstructive pyelonephritis due to renal calculus. CASE REPORT A 28-year-old woman had previously been sterilized by tubal ligation. She presented with acute pyelonephritis associated with a left staghorn renal calculus and was found to have a false-positive urine pregnancy test, which delayed the diagnosis and management of her acute pyelonephritis. On follow-up, she had a negative serum pregnancy test. Abdominal computed tomography (CT) identified a left-sided staghorn calculus resulting in partial ureteric obstruction and hydronephrosis. She was treated with antibiotics, including cefazoline, and a left nephrostomy tube was sited to treat her hydronephrosis. Her pain was initially managed with acetaminophen and hydrocodone. Four days after her initial hospital admission, the patient was stable enough to go home on oral levofloxacin and pain medication. CONCLUSIONS This case of a false-positive urine pregnancy test in a 28-year-old woman with a history of tubal ligation highlights that this association may result in the delay in the diagnosis and treatment of acute pyelonephritis.
Topics: Adult; Delayed Diagnosis; False Positive Reactions; Female; Humans; Hydronephrosis; Kidney Calculi; Pregnancy Tests; Pyelonephritis; Ureteral Obstruction
PubMed: 32210220
DOI: 10.12659/AJCR.920440 -
Reproductive Health Oct 2021South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at...
BACKGROUND
South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women's experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers' and policy makers' ideas for public sector strategies to facilitate prompt confirmation of pregnancy.
METHODS
We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis.
RESULTS
Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible.
CONCLUSION
Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.
Topics: Abortion, Induced; Female; Health Personnel; Health Services Accessibility; Humans; Pregnancy; Pregnancy, Unplanned; South Africa
PubMed: 34702283
DOI: 10.1186/s12978-021-01262-0 -
BMC Women's Health Aug 2017To evaluate the utility and acceptability of using multi-level pregnancy tests (MLPTs) at home to monitor hCG trends following assisted reproductive technology (ART).
Results of a pilot study in the U.S. and Vietnam to assess the utility and acceptability of a multi-level pregnancy test (MLPT) for home monitoring of hCG trends after assisted reproduction.
BACKGROUND
To evaluate the utility and acceptability of using multi-level pregnancy tests (MLPTs) at home to monitor hCG trends following assisted reproductive technology (ART).
METHODS
One hundred and four women presenting for ART at either Stanford Medicine Fertility and Reproductive Health Clinic (Stanford, CA) or Hung Vuong Hospital (Ho Chi Minh City, Vietnam) participated in this pilot study. Women were asked to perform the MLPT at home, primarily on days when they were also scheduled to receive standard clinic-based serum hCG testing. These tests were administered up to 6 times over the 6-week period following embryo transfer or intrauterine insemination (IUI). Concordance of serial hCG readings for each time point was assessed by comparing trends in urine MLPT results with trends in serum hCG. Stable or increasing hCG level was interpreted as an indication of a progressing pregnancy, while a declining hCG was interpreted as a lack of established or progressing pregnancy. At study end, all participants were asked about the acceptability and convenience of using the MLPT at home for monitoring hCG trends following ART.
RESULTS
Data from both urine and serum testing are available for 156 of 179 clinic visits (87.2%). There was high concordance of serial trend results between the two types of tests: among the 156 sets of serum and urine hCG data points, 150 (96.2%) showed a matching trend in hCG pattern and 6 (3.8%) resulted in a discordant trend. Seventy-three percent of women reported being satisfied or very satisfied with using the MLPTs at home. Almost all (96.6%) said that the MLPT was easy or very easy to use.
CONCLUSION
The MLPT offers women and health care providers a client-friendly diagnostic tool to detect very early pregnancy and monitor its progress.
TRIAL REGISTRATION
This study was registered on clinicaltrials.gov as NCT01846403 (May 1, 2013), and NCT01919502 (August 5, 2013).
Topics: Adult; Chorionic Gonadotropin; Embryo Transfer; Female; Humans; Patient Acceptance of Health Care; Pilot Projects; Pregnancy; Pregnancy Tests; Reproduction; Reproductive Techniques, Assisted; United States; Vietnam
PubMed: 28830483
DOI: 10.1186/s12905-017-0422-y -
PloS One 2021In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is... (Randomized Controlled Trial)
Randomized Controlled Trial
In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) initiation. Understanding the characteristics of women who use pregnancy self-tests can facilitate more targeted efforts to improve pregnancy testing experiences and entry into the ANC pathway. We conducted a cross-sectional survey among pregnant women enrolling in a pre-exposure prophylaxis (PrEP) implementation study to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall, in our study population, 17% of women obtained a pregnancy self-test from a pharmacy. Pregnancy test use was higher among employed women, women with secondary and college-level educated partners, and women who spent 30 minutes or less traveling to the maternal and child health (MCH) clinic. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing as well as developing community-based models to improve access to pregnancy testing and ANC.
Topics: Adolescent; Adult; Awareness; Cross-Sectional Studies; Female; Health Facilities; Humans; Kenya; Pre-Exposure Prophylaxis; Pregnancy; Pregnancy Complications; Pregnancy Tests; Prenatal Care; Prevalence; Self-Testing; Surveys and Questionnaires; Young Adult
PubMed: 34767573
DOI: 10.1371/journal.pone.0258578 -
Human Reproduction (Oxford, England) Apr 2018Are biomarkers of preconception stress associated with pregnancy loss?
STUDY QUESTION
Are biomarkers of preconception stress associated with pregnancy loss?
SUMMARY ANSWER
Preconception stress, as measured by basal salivary cortisol and alpha-amylase concentrations, is not associated with pregnancy loss.
WHAT IS KNOWN ALREADY
Many studies, most of which have been retrospective, have identified an association between stressful life events and perceived stress and miscarriage.
STUDY DESIGN, SIZE, DURATION
A prospective pregnancy study with preconception enrollment was conducted between 2005 and 2009. Among the 344 women who became pregnant during the Longitudinal Investigation of Fertility and the Environment (LIFE) study, 337 (98%) had salivary biomarker data for analysis.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Couples planning pregnancy were followed for up to 12 months as they tried to become pregnant and through pregnancy if it occurred. Participating women collected a basal saliva sample on the morning following enrollment and a second on the morning following their next menses to measure cortisol and alpha-amylase, biomarkers of stress. Women used home pregnancy tests on the day of expected menses. A pregnancy loss was defined as a negative pregnancy test following a positive pregnancy test, the onset of menses, or for pregnancies that survived to clinical recognition, recognition of the loss by a healthcare provider.
MAIN RESULTS AND THE ROLE OF CHANCE
Among the 337 couples, the median age of female and male partners was 29 and 31 years, respectively. Most of the women were non-Hispanic white (83%) and highly educated. There were 97 pregnancy losses reported among the 337 pregnancies. The median gestational age at loss was 6 weeks 5 days with only two losses occurring in the second trimester. Using Cox proportional hazards models, we found no clear pattern of association between two preconceptional biomarkers of stress (salivary cortisol and alpha-amylase concentrations) modeled both continuously or in tertiles and incident pregnancy loss after adjustment for confounders.
LIMITATIONS REASONS FOR CAUTION
Our prior work suggests that women enrolled in the LIFE Study had lower stress levels than women in the general population. Owing to concerns regarding participant burden, we were unable to collect serial saliva measurements, which would have allowed us to examine the association between stress in early pregnancy and pregnancy loss. Further, with regard to the measurement of perceived stress, the Cohen's Perceived Stress Scale was only administered at baseline. While every attempt was made to ensure diversity in the cohort, non-Hispanic white women were over-represented, therefore it is possible that the results might not be generalizable to all women.
WIDER IMPLICATIONS OF THE FINDINGS
In one of the largest studies in the USA to prospectively capture data on the incidence of early pregnancy loss, we found no clear association between two biomarkers of preconception stress (measured in saliva) and pregnancy loss.
STUDY FUNDING/COMPETING INTEREST(S)
This study was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (contracts #N01-HD-3-3355, N01-HD-3-3356, N01-HD-3358). There are no conflicts of interest to declare.
TRIAL REGISTRATION NUMBER
Not applicable.
Topics: Abortion, Spontaneous; Adult; Biomarkers; Female; Humans; Hydrocortisone; Incidence; Male; Pregnancy; Prospective Studies; Saliva; Salivary alpha-Amylases; Stress, Psychological; Time-to-Pregnancy
PubMed: 29490045
DOI: 10.1093/humrep/dey030 -
Journal of Women's Health (2002) Dec 2010Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) may experience significant stress during military service that can have lingering effects. Little is...
BACKGROUND
Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) may experience significant stress during military service that can have lingering effects. Little is known about mental health problems or treatment among pregnant OEF/OIF women veterans. The aim of this study was to determine the prevalence of mental health problems among veterans who received pregnancy-related care in the Veterans Health Administration (VHA) system.
METHODS
Data from the Defense Manpower Data Center (DMDC) deployment roster of military discharges from October 1, 2001, through April 30, 2008, were used to assemble an administrative cohort of female OEF/OIF veterans enrolled in care at the VHA (n = 43,078). Pregnancy and mental health conditions were quantified according to ICD-9-CM codes and specifications. Mental healthcare use and prenatal care were assessed by analyzing VHA stop codes.
RESULTS
During the study period, 2966 (7%) women received at least one episode of pregnancy-related care, and 32% of veterans with a pregnancy and 21% without a pregnancy received one or more mental health diagnoses (p < 0.0001). Veterans with a pregnancy were twice as likely to have a diagnosis of depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, or schizophrenia as those without a pregnancy.
CONCLUSIONS
Women OEF/OIF veterans commonly experience mental health problems after military service. The burden of mental health conditions is higher among women with an identified instance of pregnancy than among those without. Because women do not receive pregnancy care at the VHA, however, little is known about ongoing concomitant prenatal and mental healthcare or about pregnancy outcomes among these women veterans.
Topics: Adolescent; Adult; Afghan Campaign 2001-; Analysis of Variance; Current Procedural Terminology; Female; Humans; Iraq War, 2003-2011; Mental Disorders; Middle Aged; Military Personnel; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Tests; United States; United States Department of Veterans Affairs; Veterans
PubMed: 21039234
DOI: 10.1089/jwh.2009.1892 -
PLoS Neglected Tropical Diseases Jan 2020Large-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming...
BACKGROUND
Large-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early pregnancy. Our objective was to validate a short questionnaire which could be used by deworming program managers to identify and screen out women in early pregnancy.
METHODOLOGY/PRINCIPAL FINDINGS
In May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were performed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question 'Are you pregnant?' was 100%, at a 'cost' of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions.
CONCLUSIONS/SIGNIFICANCE
To identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manageable and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassification rates will need to be considered to optimize deworming coverage in women of reproductive age.
Topics: Adult; Female; Helminthiasis; Humans; Middle Aged; Peru; Pregnancy; Pregnancy Tests; Surveys and Questionnaires
PubMed: 31999690
DOI: 10.1371/journal.pntd.0007901 -
Acta Veterinaria Hungarica Jun 2018The early detection of pregnancy and the determination of fetal numbers have economic benefits in sheep production because of the seasonal breeding patterns where...
The early detection of pregnancy and the determination of fetal numbers have economic benefits in sheep production because of the seasonal breeding patterns where missing a breeding opportunity means the loss of one productive year. The purpose of this study was to evaluate the efficacy of the B6-HRP ELISA for ovine pregnancy-specific protein B (oPSPB) measurement in the detection of pregnancy and estimation of fetal numbers in different sheep breeds. BioPRYN® ELISA assay kit was used for the detection of pregnancy in the experimental animals. Ninety-three ewes of three breeds (British Milksheep - BM, Lacaune - L and Transylvanian Racka - TR), each from three farms in Hungary, were included in the study. BM and L ewes were artificially inseminated (AI). Thirty-five days after AI, all ewes were examined by transabdominal ultrasound. The TR flock was mated naturally over a six-week period. At the end of the mating period, the ewes were similarly examined by ultrasound. Blood samples were taken from all pregnant ewes twice (35 and 65 days after AI), and serum samples were assayed by the BioPRYN test. It can be concluded that the detection of serum PSPB by ELISA is a much easier, safer, less expensive and highly accurate method for the detection of ovine pregnancy. Although some breed-related differences were detectable at 35 and 65 days post breeding, no differences in oPSPB levels were found in pregnant ewes carrying different numbers of fetuses.
Topics: Animals; Enzyme-Linked Immunosorbent Assay; Female; Pregnancy; Pregnancy Proteins; Pregnancy Tests; Pregnancy, Animal
PubMed: 29958526
DOI: 10.1556/004.2018.029