[ozmidwifery] Pregnancy testing
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)
Re: [ozmidwifery] Pregnancy testing
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)
Re: [ozmidwifery] Pregnancy testing
Hi Anne Nothing further to add to Andreas comments except I am so glad to hear there is a debriefing opportunity for this case. Congrats on your great work up North. Wendy - Original Message - From: Anne Smith To: ozmidwifery@acegraphics.com.au Cc: Anne Smith Sent: Monday, January 08, 2007 2:16 PM Subject: [ozmidwifery] Pregnancy testing 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) -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.410 / Virus Database: 268.16.7/619 - Release Date: 1/7/2007
Re: [ozmidwifery] Pregnancy testing
Some women just never spill bHCG, and just in general you can get a false negative but pretty much never a false positive. On 08/01/2007, at 2:59 PM, Andrea Quanchi wrote: 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)
