According to statistics, one out of hundreds of pregnancies turns out to be ectopic, and recently experts have noted an increase in cases of such pathology. Everyone knows that the earlier the problem is identified, the more favorable the predictions for women's health. Therefore, women involuntarily ask the question: can a home pregnancy test show an abnormal pregnancy? This will be discussed in our article.
What do the tests show?
Any pharmacy pregnancy test is based on the determination of a specific substance that rises in a woman's body during pregnancy. This is a special hormone called hCG. Chorionic gonadotropin rises after the embryo is implanted into the endometrial layer of the uterus. This event happens 7-9 days after ovulation (variants of earlier or later embryo attachment are possible).
The substance is produced by chorionic villi, with which the ovum is attached to the uterus, and which are introduced into the bloodstream of the female body. HCG is important for the continuation of the corpus luteum, a temporary gland that forms on the ovary after ovulation. In the absence of pregnancy, the gland ceases to exist approximately 10-12 days after ovulation. Its function is the production of progesterone. This sex hormone, in turn, creates optimal conditions for the development of the fetus: it increases the endometrial layer, softens it, prevents the tone of the muscles of the uterus, the onset of the next menstruation.
In this way, chorionic gonadotropin is a kind of "support group" for progesterone.
Without hCG, the further existence of the corpus luteum in the current cycle is not possible, and a couple of days after the extinction of the corpus luteum, the next menstruation begins.
After implantation, the hCG level rises every 48 hours, doubling. With multiple pregnancies - 4 or 6 times the number of fetuses. Thus, already 3-4 days after implantation, an increase in hCG above the so-called non-pregnant rate (0-5 mU / ml) can be recorded in a woman's blood by a laboratory study of a venous blood sample, and after a couple of days the first traces of the hormone appear in urine.
Pregnancy tests contain an absorbent layer coated with a chemical reagent that is more or less sensitive to the concentration of hCG in a woman's urine. As soon as the level of chorionic gonadotropin reaches the sensitivity threshold of the test, the test zone is colored - this is the second strip.
- Ultrasensitive tests (with a threshold of 10-15 units) are able to catch traces of chorionic gonadotropin in urine already 3-4 days before the expected start date of menstruation.
- Conventional tests have a sensitivity of 20 to 30 units, and this threshold of hCG in urine usually overcomes by the first or second day of delayed menstruation.
Features of ectopic implantation
With an ectopic pregnancy, the embryo is implanted not where it is provided by nature for safe growth and development (in the uterus), but on the way to it - as a rule, in one of the fallopian tubes, where fertilization took place. The fact is that after conception, the zygote has to move along the fallopian tube towards the uterus for three days. And at this stage, certain difficulties may arise, in connection with which the ovum will be delayed and implanted as a result, but not at all where there are conditions for it, but in the abdominal cavity, ovary, tube, and sometimes in the cervix.
Experts say that the number of cases of ectopic pregnancy has increased fivefold over the past 10 years... And every fifth ectopic pregnancy recurs, that is, it happens again. This pathology is considered a very dangerous complication that can lead to the development of infertility or even the death of a woman if the anomaly is not diagnosed in time. The main danger is that the embryo, wherever it is attached, continues to grow for some time, as long as space allows.... And its growth can cause rupture of the organ in which the freelance implantation of the ovum has occurred.
According to medical statistics, implantation in a tube occurs in 97% of cases.
Moreover, in half of the cases of tubal pregnancy, the embryo remains where fertilization was, that is, in the ampullar part (the widest part of the oviduct). 40% of cases are the attachment of the embryo in the middle part of the oviduct, and in 10% of cases the embryo is attached in the area of the fimbriae. The rest of the sites of possible implantation are rare. Given the mortal danger that a woman is exposed to (in the event of an organ rupture, severe internal bleeding occurs, in which it is not always possible to provide effective surgical care), all the efforts of doctors are thrown into the diagnosis of abnormal pregnancy at the earliest possible date.
What are the signs of an ectopic pregnancy? At the initial stage, it almost does not differ from the usual one - even with an ectopic attachment a certain amount of hCG is produced (reduced compared to the norm), menstruation does not come, a delay begins. But after a delay or some time later, bloody, spotting, pulling pain in the lower abdomen or on the right (left) side - depending on the place of attachment of the fetus.
May manifest early nausea, lack of appetite, the mammary glands become dense, painful. Such symptoms are unlikely to help distinguish a normal pregnancy from an abnormal one, especially for those uninitiated in the nuances of obstetrics. And when there is an interruption of the ectopic hemorrhage with intra-abdominal hemorrhage, there is no time and need to assess the signs - sharp pain, distention in the abdomen, profuse bleeding from the genitals, loss of consciousness, a drop in blood pressure leave no time for thought. An urgent need to hospitalize the patient in a hospital that has the ability to provide emergency surgical care.
In any case, an ectopic pregnancy, whenever detected, cannot be saved. The embryo is removed, sometimes with a part of the tube or organ into which the embryo has grown with chorionic villi. The most dangerous is a cervical pregnancy, with which it is often necessary to remove the entire uterus completely.
The reasons why the fertilized egg can attach not in the uterus, but in another place, are numerous. A woman's endometriosis, previous abortions, long-term use of oral contraceptives, an installed spiral can interfere with the normal advancement of the embryo. The risks of ectopic IVF increase.
Often, the reason lies in operations that were previously performed on the appendages, neoplasms in the uterus, and previously suffered chlamydia.
The definition of an ectopic at an early date is very difficult. Symptoms are atypical. Much of what a woman feels is typical of a normal pregnancy: odd perception of taste and olfactory signals, lack of menstruation, signs of early toxicosis. Unfortunately, even on examination by a doctor, the secret may remain unsolved. The only informative methods today are considered hCG blood test and diagnostic laparoscopy.
A blood test shows a slow increase in the level of chorionic gonadotropin, its significant decrease in comparison with uterine pregnancy. Laboratory results can be confirmed by ultrasound, as well as by laparoscopic surgery, which allows not only to accurately establish the pathology, but also to immediately take measures to eliminate it with maximum efforts thrown into the preservation of the organs of the reproductive system in all cases, when possible.
Home test - results with WB
A home test, even the most modern, digital, electronic, cannot establish the quantitative content of the hCG hormone in the urine. It only shows whether there is an excess of chorionic gonadotropin in the body or not. And therefore, with an ectopic pregnancy, a test conducted independently at home can be both positive, showing two stripes, and negative, showing only one strip.
Before the delay of menstruation, usually during uterine pregnancy, traces of the hormone in the urine are captured only by ultrasensitive tests. But in the case of ectopic implantation, the level of hCG is several times lower both in the blood and in the urine, and therefore it is not worth counting on the fact that before the expected date of menstruation the test will show at least something.
After a delay (usually with a delay of several days), you can get a positive result due to the accumulation of hCG concentration, but usually the hormone level remains insufficient for two clear stripes, and the test reacts weakly to a low hCG level - the second stripe looks faintly colored, indistinct, blurred.
Regardless of which organ or part of it the embryo is attached to, the level of chorionic gonadotropin will be reduced, but it will also grow, only very, very slowly.
Therefore, the test detects an abnormal pregnancy, but with an interesting nuance - the strip does not become brighter when re-tested the next day, two days later.
Quite often, such tests are perceived by the ladies as dubious, they “sin” on test manufacturers, brands, on their own mistakes when conducting home diagnostics. But the new tests done do not clarify the situation - the second strip remains less saturated than the control one, which clearly indicates, if not an ectopic, then a decrease in the level of chorionic gonadotropin for some other reason.
Important! If you use more accurate electronic or digital tests, you are more likely to remain delusional longer. They show no faint streaks or questionable results. You can get either positive or negative results.
In any case, if you received a "dubious" test, you should contact the clinic and take a blood test for hCG - quantitative indicators, especially if the analysis is carried out twice with a difference of two days, will be much more informative data for establishing an appropriate diagnosis than blind guesses by stripes. If a pathology is suspected, an expert ultrasound is performed.
There is no specific test for ectopic pregnancy. And a blood test can be considered as such. There is no need to be afraid of the prospect of donating blood - the procedure is quick, simple, the price of the analysis is affordable (from 300 to 600 rubles, depending on the clinic and region), and the results are accurate like no others - up to 99.9%. If a woman falls into the risk group for an ectopic pregnancy, then you can get a referral from a gynecologist for free blood tests, they will be done in consultation, you will not have to pay for the study.
How to do the analysis?
It is very important to determine the possible gestational age, if any. For this, the first day of the last menstruation is considered the first day of pregnancy. Thus, after a delay in menstruation, a woman is already in her fifth obstetric week, and she is characterized by a high content of hCG in the blood - from 2.5 thousand IU / ml to 83 thousand IU / ml. If the pregnancy is ectopic, then in the week following the onset of the delay, the woman's blood will be found to be 1000 IU / ml and above.
It's hard to say the norms, there are none, but it is very important to do the analysis not once, but several times in order to trace the growth of human chorionic gonadotropin in dynamics.
If a woman donated blood three times in a week, and growth is noted no more than 1.5-2 times in seven days, there is every reason to assume the presence of an ectopic embryo attachment.
A blood test for hCG is done in the morning on an empty stomach. In the evening, it is undesirable to eat fatty foods. The last meal before analysis should be 7–8 hours before, not earlier. The analysis does not require any other special preparation. Blood is taken from a vein. Results will be available the same day or the next. Decoding is not worth doing on your own - only a medical specialist can see certain trends in the growth of the concentration of the hormone in the blood.
