Immunologic diagnosis of pregnancy in miniabortion
Rajan, R.; Devi, L.U.; Venkitakrishnan, S.; John, R.
Journal of Obstetrics and Gynaecology of India 29(1): 26-31
1979
ISSN/ISBN: 0971-9202 PMID: 12326932 Document Number: 575244
In an attempt to minimize the incidence of the non-pregnant woman undergoing endometrial aspiration, 105 women reporting with short period of amenorrhea -- 10-21 days past the expected menstrual period -- and desiring endometrial aspiration were considered for evaluation at the Medical College Hopsital (Kottayam, India) over the March 1977-December 1977 period. All were parous women, with the majority in the low parity group. A careful pelvic examination was performed to elicit the early pregnancy changes in the uterus and a routine urinary pregnancy test was done. In 105 women early diagnosis of pregnancy was attempted with immunological test, as a preliminary to endometrial aspiration. In the presence of a positive pregnancy test the aspiration was carried out. Of the 64 women who had a positive pregnancy test, 61 were documented to be pregnant by histopathological examination of the aspirate. None of the readily available methods for pregnancy diagnosis can detect pregnancy before the women is at least 10 days past the expected menstrual period. Endometrial aspiration performed within this period becomes a poor and interim procedure of pregnancy termination, with as many as 50% remaining non-pregnant. Immunological test for pregnancy, performed after the 10th day of expected menses, ensures a diagnostic accuracy of 96% for positive results, but negative results are unreliable and carry an error of 20%. Endometrial aspiration performed between 10th and 21st day of expected menses, without a preliminary immunologic diagnosis of pregnancy, ensures a pregnancy termination rate of 86%.