Abstract

PIP: There has been a tremendous development in the area of simple pregnancy tests. Generally, the new products possess increased sensitivity, shorter analysis times and, not least, the tests can be used on serum samples. Since a number of early pregnancies end up being aborted (up to 65%), there is a continuing need for sensitive tests for detecting ordinary pregnancy with urine tests. These tests, which are preferably of the "plate type," should have a sensitivity of around 500 IE/1. They will show positive after 1-2 weeks following a missing menstruation cycle, when the greatest risk of abortion is over. These types are not further discussed here, since the emphasis in this study is on detecting ectopic pregnancy. The diagnostics/differential diagnostics regarding the increasing number of ectopic pregnancies have become a serious problem for surgical and gynecological wards, since serious medical emergencies can arise if detection is not made. Since pathological pregnancies often have abnormally low HCG production, there is great interest in finding sensitive, rapid and reliable tests for such situations. A trial was made in 1986 using 37 women in Aker Hospital, Norway for treatment of acute abdominal pains, and with possibly ectopic pregnancy. Their urine and serum was immediately deep frozen in portions and then tinted for examination. Final diagnosis was done with the aid of clinical observations, histology and HCG findings in the urine and serum samples using the reference method. Analysis was based on RIA, radio immunoassay. 5 Norwegian products were compared as to sensitivity, method of testing and cost. Results showed serum values for 10 non-pregnant subjects of between 10 and 23 IE/1, while corresponding serum values were around 5 or 6 IE/1. The HCG values of 5 patients with normal pregnancies showed a close correspondence between urine and serum values, with some individual variation. The HCG values of 10 patients with ectopic pregnancies had a much wider variation between corresponding urine and serum values, showing 7-10 for urine positive and 3-10 for serum positive. It was also found that the most sensitive urine tests gave positive readings with all the patients having ectopic pregnancy, while the less sensitive tests failed to the degree sensitivity declined. No false reactions were given with any of the tests, nor were there any false negatives because of the prosone phenomenon. The most sensitive brands tested were Neo-Pregosticon 75 Duoclon and Tandem Icon HCG.