[Urinalysis--urine dry chemistry test, pregnancy test, ovulation prediction test, urinary albumin analysis].
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Pregnancy tests have sufficiently low detection limits (25-200 IU/L of human chorionic gonadotropin, hCG) and good specificity as judged by lack of cross-reaction with lutropin (LH) and follitropin (FSH). However, little information is available on the specificity of the tests for subunits and fragments of hCG. The dominating form of hCG immunoreactivity in pregnancy urine is actually a 10 kD fragment of the beta chain of hCG called the core fragment. We have evaluated ten commonly used pregnancy test with respect to specificity for various forms of hCG and detection limit. Our results show that the detection limits of the tests are close to that claimed by the manufacturers and that the main form of hCG immunoreactivity detected is intact hCG. Four of the tests also measure the free beta subunit of hCG and one method also the hCG beta core fragment, but the detection limits were 7-70 fold those for hCG.
Pregnancy tests have become quite reliable since the introduction of monoclonal antibody procedures. Even home kits use this technology and are greatly improved over earlier versions. However, as Dr Bluestein explains, use of these tests must be accompanied by an understanding of factors that can cause false results. He describes these factors and points out the need for further testing and obstetric consultation in some situations.
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The menu of tests available at the point of care continues to expand. Many of these tests present unique opportunities to deploy point-of-care technologies in the home, outpatient, and hospital settings. The future will inevitably create new applications for POCT. The success of these efforts will be in part determined by how technologies for specific applications are selected and by the ability to manage new point-of-care tests as part of an organizational point-of-care program. The possibilities to improve patient care are obvious, provided adequate attention is paid to ensuring quality testing and to managing patient data from these novel technologies.
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An evaluation in terms of performance and cost was made of the Planotest, Pregnex, Gravindex, Prepurex, Planosec, Quick Test and Dap Test pregnancy test kits. It was found that Pregnex was the most accurate, but that it was expensive. Planotest, Gravindex and Prepurex were identical as far as results were concerned and they were comparable in price. In terms of readability, Gravindex, Pregnex and Prepurex were considered the easiest. Because many pregnancy test kits are available, we thought it desirable to compare these kits in terms of cost and performance.
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Urine pregnancy tests performed at a large urban university student health center were examined for specific gravity to determine whether a low urine specific gravity, compared with a serum specimen, could alter the result of a urine pregnancy test. At the same time, a serum pregnancy test was performed on those samples with negative results and a specific gravity of less than 1.015. During the study period, 410 urine specimens were evaluated. Eighty of the women with a specific gravity under 1.015 had negative urine pregnancy tests with a concomitant serum specimen. The authors concluded that current sensitive immunoassay tests for human chorionic gonadotropin (HCG) are highly sensitive and that low specific gravity does not appear to alter this sensitivity.
The Subhuman Primate Pregnancy Test kit was used for diagnosis of pregnancy in 15 baboons. This hemagglutination inhibition test for urinary chorionic gonadotropin accurately indicated conception by positive responses in 106 of 109 specimens collected between 17 and 30 da after the estimated day of fertilization. Maximum hormone levels were reached during the middle of this 14-da interval. The rate of false positive and false negative results did not exceed 1%.
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