Anne the pregnancy test reading levels of bHCG which are elevated
only in the first trimester and peak at 60-90 days post conception.
They then decrease after 10-11 weeks and plateau at 100-130 days at
a lower level that is maintained until birth and is not detectable by
2 weeks post birth. What the sensitivity of the test is I am not
exactly sure but the answer is probably both these things. The level
was not high at this stage so by the time the baby had been dead for
a week the level was low enough not to be detected by the test.
Hope this helps
Andrea Q
On 08/01/2007, at 2:16 PM, Anne Smith wrote:
I have a question for you wise women – will give you some
background first.
Young woman with a concealed or unacknowledged pregnancy at 26
weeks presented with acute abdominal pain to a remote area health
clinic. No midwife was present and doctor had not practiced
obstetrics for “years”.
The woman did not appear pregnant at all. They did a pregnancy
test and it was negative. They thought that renal colic may have
been the cause. No one could palpate contractions but eventually
the doctor did a VE and discovered “something there”.
A very experienced nurse then “delivered” (and I use the word
advisedly), the baby which was in a breech position. Traumatic for
everyone especially the woman, who was then transferred by plane to
the nearest hospital. I will be attending a debriefing session on
Friday and would like to be able to at least explain the negative
pregnancy test.
Was this due to the demise of the baby (perhaps up to a week
previously) or have the hormones altered so much that the test will
not react -
a. because of FDIU or
b. advanced pregnancy or
c. was there a technical problem with the
test itself
Your input would be much appreciated.
Keep up the discussions on why women don’t choose or don’t know to
choose more wisely when contemplating pregnancy because we do have
a responsibility as midwives for disseminating this knowledge.
Many thanks
Anne (in the NT)
