BETA HCG QUALITATIVE TESTING (PREGNANCY TEST)

The HCG beta-subunit becomes detectable 6-12 days post implantation. (1) A b-HCG level of >25 IU/L is required for a definitive confirmation with methods used at the IMVS. IU/L <5 5-25 >25 Interpretation Negative Equivocal Positive

At levels of 1,500 - 2,000 IU/L an intrauterine gestational sac becomes visible on ultrasound examination. Rate of b-HCG increase in pregnancy

(2)

b-HCG doubles every 1.5 days for 5 weeks post implantation b-HCG then doubles every 3.5 days from the 7th week post implantation

REFERENCE INTERVALS FOR b-HCG IN PREGNANCY Gestational Age weeks (post LMP) 2-3 3-4 4-5 5-6 6-8 8-12 14 15 16 17 18 IU/l 10-70 10-750 200-7000 200-32,000 4,000-150,000 64,000-210,000 14,000-62,000 12,000-70,000 9,000-56,000 8,000-56,000 8,000-58,000
(3)

Ectopic Pregnancy and Abortion Indicated by:

Falling levels of b-HCG

Reduced rate of increase (Note: Approximately 1/3rd of cases of tubal pregnancy have normal rates of b-HCG level increase)

The IMVS recommends that serial assays for bHCG be performed in the same laboratory as variations in methods could lead to an inaccurate assessment of the situation. 1. Wilcox A, Baird DD, Weinberg CR. Time of implantation of the conceptus and loss of pregnancy. NEJM 1999;340:1796-99 2. Fits MA, Guo SM. Doubling time of hCG in normal pregnancy: relationship to hCG concentration and gestational age. Fertility and Sterility 1987;47:584-589 3. Shepherd HR, Patton PE, Novy MJ, Burry KA. Serial data hCG measurements in the early detection of ectopic pregnancy. Obstetrics & Gynecology 1990;75:417-420