By Ann M. Gronowski
Working towards experts in pathology, laboratory drugs, and obstetrics comprehensively summarize the newest medical findings and their reviews within the use and interpretation of laboratory trying out in sufferers who're pregnant or experiencing recurrent being pregnant loss. themes of curiosity contain the results of ordinary physiological alterations on try out effects, try choice for analysis, alterations in reference levels, tracking the pregnant sufferer, new applied sciences, and the restrictions of laboratory trying out. The authors not just truly clarify presently used try equipment and applied sciences for the nontechnical reader, but in addition offer complete info for laboratory pros. the excellent appendix that compiles released common reference levels via first, moment, and 3rd trimester consttitutes a superb source for pros taking care of pregnant ladies.
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Extra info for Handbook of Clinical Laboratory Testing During Pregnancy (Current Clinical Pathology)
Example text
10b. Aswood ER. Clinical chemistry of pregnancy. In; Burtis CA, Aswood EK, eds. Tier Textbook of Clinical Chemistry, 3rd ed. Philadelphia, Saunders, 1998;1736–1775. 11. Kovaleskaya G, Genbacev O, Fisher SJ, Caceres E, O’Connor JF. Trophoblast origin of hCG isoforms: cytotrophoblasts are the primary source of choriocarcinoma-like hCG. Mol Cell Endocrinol 2002;94:147–155. 12. Cole, LA, Immunoassay of hCG, its free subunits and metabolites. Clin Chem 1997;43:2233–2243. 13. O’Connor JF, Ellish N, Kakuma T, Schlatterer J, Kovalevskaya G.
The transient decreases were likely an interim weakening of the immune system after chemotherapy or surgery, reducing circulating heterophilic and antianimal antibody concentrations, leading to decreased false-positive hCG results. SUMMARY hCG is a complex glycoprotein that is produced by the trophoblastic cells of the placenta during pregnancy and in gestational trophoblastic diseases. Concentrations of hCG rise very rapidly during early pregnancy and peak at approx 8 and 12 wk. Numerous quantitative and qualitative assays for detecting hCG in serum or urine are available.
Pregnancy detection is itself problematical because of variation in the timing of initial hCG production by individuals, wide variation in the extent of hCG production, and hCG production by early pregnancy losses. Further limitations of the hCG assays themselves include manufacturing defects, the hook effect, and heterophilic antibodies. Considering these observations, great care is needed in the use and interpretation of pregnancy tests. Home pregnancy tests and point-of-care pregnancy tests should be considered as indicators of pregnancy, and confirmation of pregnancy should be obtained using a quantitative serum assay.