Pregnancy laboratory tests

Because the sheer magnitude of the tests performed in laboratory diagnosis is so great, e.g., over 3,600 tests in the alphabetical index of the laboratory tests offered by UCLA Medical Center [4], a single example will be illuminated to demonstrate a particular use of biologically derived diagnostics in home pregnancy test. 

Infection Instruct patients treated with succimer to report promptly any signs of infection. If infection is suspected, immediately conduct the above laboratory tests. Pregnancy Category C. 

Gronowski AM. Handbook of clinical laboratory testing during pregnancy. Totowa, NJ Humana Press, 2004. 

To appreciate the role of laboratory tests in pregnancy health care, it is necessary to understand fundamental topics, such as conception, embryo development, fetal growth, the role of the placenta, the importance and composition of amniotic fluid, maternal adaptation to pregnancy, and functional maturation of the fetus. 

One of the most important placental hormones is CG. CG stimulates the ovary to produce progesterone which, in turn, prevents menstruation thereby protecting the pregnancy. The chemistry, biochemistry, and methods for CG are discussed in the section on laboratory tests later m this chapter. 

Figure 54-3 Concentration of chorionic gonadotropin (CG) in maternal serum as a function of gestational age. Lines represent the 2nd, 50th, and 97th percentiles.The maternal serum values from 14 to 25 weeks are medians calculated from 24,229 pregnancies from testing performed at ARUP Laboratories Inc, from January to October 1997, fRedrawn fromAshwood R. Evaluating health and maturation of the unborn the role of the clinical laboratory. Clin Chem 1992 38 1523-1529. Permission granted from Clin Chem.)...

Figure 54-12 Concentrations of alpha fetoprotein (AFP) in fetal and newborn serum, maternal serum, and amniotic fluid. The maternal serum values are medians calculated from 24,232 pregnancies and the amniotic fluid values are medians calculated from 1544 pregnancies from testing performed at ARUP Laboratories Inc. from January to October 1997.The fetal serum values are from Gitlan. The newborn serum values are from Wu et aU "...

Specific laboratory tests to investigate the possible presence of von Willebrand disease include measurement of von Willebrand factor antigen (vWF Ag) level, factor VIII assay, determination of ristocetin cofactor activity, and von Willebrand factor multimer analysis. Plasma concentrations of von Willebrand factor increase with cigarette smoking, exercise, pregnancy, and infection, as well as with the use of certain medications, such as corticosteroids, birth control pills, and desmopressin. Repeated test measurements may be... 

Treatment of chlamydial infections with the recommended regimens is highly effective therefore, posttreatment laboratory testing is not recommended routinely unless symptoms persist or there are other specific concerns (e.g., pregnancy). Posttreatment tests should not be performed for at least 3 weeks following completion of therapy. When posttreatment tests are positive, they usually represent noncompliance, failure to treat sexual partners, or laboratory error rather than inadequate therapy or resistance to therapy. Infants with pneumonitis should receive follow-up testing because erythromycin is only 80% effective, and a second course of therapy may be necessary. ° " ... 

Monitoring concentrations of female hormones is important for female disease diagnostics as well as for fetal health monitoring. The most important female cycle biomarkers, which are typically measured in clinical laboratory tests or commercial test strips, include follicle stimulating hormone (FSH) as a marker of non-pregnancy, luteinizing hormone (LH) as a marker of ovu-... 

The first half of the twentieth century witnessed the discovery of the three most important hormones involved in reproduction, the female hormones estrogen and progesterone, and the male hormone testosterone. Soon after, companies began to manufacture the first synthetic hormones for the treatment of infertility. In 1944, the first laboratory test showing that human oocytes could be fertilized in vitro was carried out. Thirty-four years later, the first so-called test-tube baby was born in England, and sperm banks became more common. The late twentieth century saw two more milestones in infertility treatment the first successful implantation and pregnancy with an egg that had been cryopreserved and the development of intracytoplasmic sperm injection technology. 

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