Home Pregnancy Test and Urinary Hcg Compared to Ultrasound Assessment of Pregnancy Duration

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  Human Chorionic Gonadotrophin (hCG) is produced at the earliest stages of pregnancy such that it can be detected in urine as early as 7 days following ovulation, if highly sensitive immunoassays are used, and as early as 9 days with home pregnancy tests.Levels rise exponentially in early,ongoing pregnancy.When start of pregnancy is aligned by day of ovulation rather than last menstrual period (LMP), levels ofhCG in urine are sufficiently similar between volunteers (including different ethnicities/races), to enable urinary hCG concentration to be related to pregnancy duration, at least in the first few weeks of pregnancy.This has enabled the development of a home pregnancy test that as well as giving a pregnancy result provides an estimation of pregnancy duration.Studies on both the accuracy of urinary hCG, and the home pregnancy test in correctly assessing pregnancy duration have been conducted, comparing to both luteinising hormone (LH) surge as a marker for of day ovulation, and first trimester ultrasound (Crown Rump Length Measurement, both under a controlled clinical setting and standard-of-care setting).When ultrasound was used as a reference, median hCG concentration was lower on each day, compared to using LH.This was due to pregnancy duration being on average 3 days more when calculated by ultrasound compared to LH surge.The home pregnancy test was found to assess pregnancy duration with an accuracy of 92% when compared to LH surge and 98% agreement with standard-of-care ultrasound.
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