Pregnancy Tests

Current pregnancy tests use immunoassays with monoclonal antibodies to measure the beta subunit of human chori-onic gonadotropin (hCG). Serum assays and sensitive urine assays can now detect pregnancy approximately 1 week after conception. Home pregnancy tests are generally sensitive enough to diagnose pregnancy accurately when done on the first day of the missed period. The most common reason for a false-negative pregnancy test is incorrect timing, such as performing the test too soon.

In the first 4 to 8 weeks of pregnancy, hCG levels double approximately every 2 days. Failure to double in 48 to 72 hours suggests an ectopic pregnancy or abnormal intrauterine pregnancy. For the first 2 weeks after conception, serum levels of hCG are higher than those in urine. However, beginning at approximately 3 weeks and for the remainder of the pregnancy, urine levels are higher than serum levels. Levels of hCG return to normal approximately 2 weeks after delivery. After an abortion, levels return to normal in approximately 3 to 8 weeks. Other conditions that can raise hCG levels include ges-tational trophoblastic neoplasms, such as hydatidiform mole and choriocarcinoma.

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