Suggest possible tests to confirm pregnancy
Patient: HI sir/madam,my wife's age is 27yrs and her last mensus date was jan1 2014,on feb 5 we conducted home pregnancy test and there appeared a very thin line on the positive side,we confused that it is really positive or not,on feb 8 we consulted doctor and she repeated the test there appeared again a very thin line,doctor said that there must be a chance and hope for the best,and said that to wait for 10 days and consult her.doctor gave medicines for 10 days i.e  ferrous-xt tablets and  arg 9 powder,we are in a great confusion that it is positive or not,kindly guide me... Doctor: Hallow Dear,The first test you performed was rather too early, hence confusing results. Ideally, the pregnancy tests on urine should be performed 8-10 days after missed period on overnight early morning first urine sample for reliable results. Done earlier, the tests may be false negative. However, there is another test - Beta hCG test which can give reliable results even few days before missing period. However, even after 8 days you have got the faint positive line; i.e. weak positive test, it suggests that the hormone hCG is low. This happens commonly in following conditions:1. Test performed too early - may be delayed conception. 2. When the baby has become non-viable. This is known as missed abortion. Then hCG gradually starts declining and hence week positive test.3. Ectopic pregnancy: In this condition the baby is implanted somewhere outside the uterine cavity, most commonly in the tube. It is a very serious condition. Subsequently tube ruptures and causes alarming bleeding. It needs blood transfusion and surgical intervention.   The best option for differential diagnosis is ultrasonography. In normal pregnancy, intrauterine sac will be seen with foetal cardiac activity.In non-viable baby (missed abortion), the foetal heart will be missing and sac will be irregular. In such cases timely termination of pregnancy is indicated lest the serious complications like threatening bleeding due to clotting defects (DIC), infection, kidney failure, etc. If the uterine cavity is empty in spite of (weak) positive test, it indicates that the implantation is somewhere else; i.e. ectopic pregnancy. Laparoscopy will help to confirm the diagnosis. If it is unruptured ectopic pregnancy, it can be managed by laparoscopy only. Please report to your Gynaecologist and undergo ultrasonography for correct diagnosis and managing the pregnancy appropriately. I am sure this helps you. Dr. Nishikant Shrotri