hCG blood test
hCG blood test or pregnancy blood test measures the accurate amount of pregnancy hormone, human chorionic gonadotropin (hCG) in the bloodstream. Pregnancy hormone hCG is produced by the placenta. It can be assessed in the blood and urine of a woman within 10 days of fertilization. hCG can be measured by:
Quantitative pregnancy blood test: This test measures the accurate amount of hCG in the blood of a woman and plays a vital role in assessing the age of the fetus. This test also helps in checking if the pregnancy is developing normally.
Qualitative pregnancy blood test: This test can only tell if there is hCG present in the blood and can give no further information. This test result is like the home based pregnancy test kit just giving a 'yes' or 'no'.
In men and non pregnant women, the typical levels of hCG is less than 5 international units per liter (IU/L). In pregnant women, it is about 5 - 100 during 24 to 28 days after last menstrual period (LMP). During 4 to 5 weeks after the LMP, the hCG is about 50-500 IU/L and peaks to about 12,000 - 270,000 IU/L during 14 - 16 weeks of pregnancy. High levels of hCG can signify multiple pregnancy or molar pregnancy or Down's syndrome. In non-pregnant women and in men, it can signify cancerous or non-cancerous tumor of the testicles or ovaries. Low values of hCG in pregnant women can signify ectopic pregnancy, death of baby or that the pregnancy is not proceeding the way it has to. It can also indicate a spontaneous miscarriage.
Tubal Pregnancy
Tubal pregnancy is also known as ectopic pregnancy - a condition where the fertilized egg implants itself in the fallopian tubes or any other tissue outside of the uterus. Tubal pregnancy can be life threatening, if not attended to in time. This is because it can lead to the rupture of the pelvic organ and consequent hemorrhage. It can also affect the woman's ability to become pregnant later.
Since it is impossible to carry a tubal pregnancy to term, it becomes imperative to resort to surgery to remove the products of conception since they cannot develop into a fetus. This is done without damage to fallopian tubes, as far as possible. This can be done with laparoscopy in non-emergency situations. Tubal pregnancy can happen to any woman but there are some causes that can increase the likelihood of such a pregnancy condition. Some of the causes for tubal pregnancy are: Pelvic Inflammatory Disease, endometriosis or tubal scarring. Infection of the fallopian tubes such as gonorrhea or chlamydia can lead to a tubal pregnancy. The risk of ectopic pregnancy is manifold in cases of pregnancy after tubal sterilization. The use of the 'morning after pill' - emergency contraception is often noticed as a cause for tubal pregnancy.
An ectopic pregnancy is usually detected in the first 5 - 10 weeks of pregnancy. Ultrasound tests and hCG levels in the blood can help in identifying an ectopic pregnancy. The rate of increase of hCG in the blood is much slower in the case of an ectopic pregnancy or a potential miscarriage. Lower progesterone levels can also be an indication of likely tubal pregnancy. A woman having a tubal pregnancy will experience lower abdominal pain with cramping. There may be abnormal vaginal bleeding and breast tenderness. Lower back pain is another symptom. Severe bleeding and hemorrhage is the most dangerous symptom of ectopic pregnancy and needs prompt medical attention. If there is an emergency situation, there may be a need for blood transfusion.
Spontaneous Abortions
Spontaneous abortion occurs when there is loss of fetus during fetus. Spontaneous abortion or miscarraige happens due to natural events and must not be confused with an elective abortion. Typically, most spontaneous abortions take place during the first trimester. Usually a miscarriage occurs anywhere between 7 - 12 weeks of pregnancy. It can even occur before a woman realises that she is pregnant. Spontaneous abortion can occur due to infection, trauma, immune response by the body or other conditions such as diabetes. The risk of such miscarraige is higher in women who are above 35 years or suffering from systemic conditions such as thyroid or diabetes. Endocrine factors such as Hypothyroidism, hypoprolactinemia or polycystic ovarian syndrome can bring on a spontaneous abortion. Chromosomal abnormalities, sexually transmitted diseases or immunological reactions can trigger a miscarraige.
A woman may experience vaginal bleeding that may contain tissue or clots. There is low back pain or abdominal cramps. Other symptoms of impending miscarraige are fever, headache and high blood pressure. Blood tests to check levels of HCG (human chorionic gonadotropin) are done. An ultrasound helps in confirming whether there has been a spontaneous abortion or not. It can detect the presence of a live fetus and fetal heart beat. It is essential to consult the healthworker when such symptoms are noticed. Not all bleeding in the first trimester leads to spontaneous abortion.
In cases of threatened abortion, the expectant mother will be advised complete bed rest. In some women, an incompetent cervix can lead to a threatened abortion. In such cases, a suture is placed around the cervix to close the cervical canal. But this has to be closely monitored. Environmental factors such as smoking or contracting rubella can threaten a pregnancy. Women who have had repeated miscarriages need to be tested to identify the cause. This may involve genetic testing of the partners and inspection of the uterus and cervix.
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