Hormon hCG dan uji kehamilan

Posted on Juli 19, 2008 by kuliahbidan

Dua garis pada alat uji kehamilan, tentunya membuat pasangan yang sudah menanti-nantikan hadirnya sang buah cinta kontan melonjak gembira. Sebuah metoda tes kehamilan yang mudah, murah dan praktis. Test pack yang bisa dibeli di hampir setiap apotek ini di dalamnya memiliki zat yang bereaksi dengan hormonkehamilan, human Chorionic Gonadotropin (hCG), dan berubah warna jika hCG ini terdeteksi dalam air seni. Hormon Kehamilan

Kira-kira sepuluh hari setelah sel telur dibuahi sel sperma di saluran Tuba fallopii, telur yang telah dibuahi itu bergerak menuju rahim dan melekat pada dindingnya. Sejak saat itulah plasenta mulai berkembang dan memproduksi hCG yang dapat ditemukan dalam darah serta air seni. Keberadaan hormon protein ini sudah dapat dideteksi dalam darah sejak hari pertama keterlambatan haid, yang kira-kira merupakah hari keenam sejak pelekatan janin pada dinding rahim. Kadar hormon ini terus bertambah hingga minggu ke 1416 kehamilan, terhitung sejak hari terakhir menstruasi. Sebagian besar ibu hamil mengalami penambahan kadar hormon hCG sebanyak dua kali lipat setiap 3 hari. Peningkatan kadar hormon ini biasanya ditandai dengan mual dan pusing yang sering dirasakan para ibu hamil. Setelah itu kadarnya menurun terus secara perlahan, dan hampir mencapai kadar normal beberapa saat setelah persalinan. Tetapi adakalanya kadar hormon ini masih di atas normal sampai 4 minggu setelah persalinan atau keguguran. Perkiraan Kadar hCG dalam Darah kehamilan trimester kedua

Perempuan yang tidak hamil dan laki-laki 24-28 hari setelah haid terakhir 4-5 minggu (1 bulan) setelah haid terakhir Ibu hamil: 5-6 minggu setelah haid terakhir 14-16 minggu (4 bulan) setelah haid terakhir 3.000-50.000 IU/L

Kurang dari 5 IU/l (international units per liter) 5100 IU/L 50500 IU/L 10010.000 IU/L 12.000270.000 IU/L

kehamilan trimester ketiga 1.000-50.000 IU/L Perempuan pasca menopause Kurang dari 10 IU/l

Kadar hCG yang lebih tinggi pada ibu hamil biasa ditemui pada kehamilan kembar dan kasus hamil anggur (mola). Sementara pada perempuan yang tidak hamil dan juga laki-laki, kadar hCG di atas normal bisa mengindikasikan adanya tumor pada alat reproduksi. Tak hanya itu, kadar hCG yang terlalu rendah pada ibu hamil pun patut diwaspadai, karena dapat berarti kehamilan terjadi di luar rahim (ektopik) atau kematian janin yang biasa disebut aborsi spontan.

Uji Kehamilan Alat uji kehamilan untuk dipakai di rumah (home pregnancy test, HPT) yang biasa dikenal dengan test pack merupakan alat praktis yang cukup akurat untuk mendeteksi kehamilan pada tahap awal. Cara penggunaannya relatif mudah, yaitu mencelupkan ujung alat ke dalam air seni yang ditampung atau menyentuhkan pada aliran air seni ketika buang air kecil. Biasanya dianjurkan penggunaan air seni pertama setelah bangun pagi, karena konsentrasi hormon hCG yang tinggi pada saat itu.

Alat uji kehamilan semacam ini biasanya memiliki dua buah jendela atau garis. Garis yang pertama mengisyaratkan bahwa tes dilakukan dengan benar, yang biasa disebut dengan garis kontrol. Garis kontrol akan tampak bila test packmendapatkan cukup air seni untuk diuji. Sementara garis kedua menunjukkan hasil tes, yang merupakan bagian alat yang memiliki antibodi yang bereaksi dengan hCG dan dapat berubah warna bila hormon ini terdeteksi. Setipis apapun garis ini, kemunculannya tetap menunjukkan adanyakehamilan. Sebagian besar merk test pack yang beredar di pasaran sudah dapat mendeteksi hCG dengan kadar 25 IU/L-50 IU/L, sehingga cukup akurat untuk menentukan ada atau tidaknya kehamilan pada hari pertama keterlambatan menstruasi (sekitar 28 hari setelah menstruasi terakhir). Uji kehamilan yang lebih akurat tentunya adalah tes kuantitatif hormon hCG dalam darah. Biasanya yang diukur adalah jumlah subunit beta hormon hCG (-hCG).

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Human Chorionic Gonadotropin (hCG)

The human chorionic gonadotropin (hCG) test is done to check for thehormone hCG in blood or urine. Some hCG tests measure the exact amount and some just check to see if the hormone is present. HCG is made by the placenta during pregnancy. The hCG test can be used to see if a woman is pregnant or as part of a screening test for birth defects. HCG may also be made abnormally by certain tumors, especially those that come from an egg or sperm (germ cell tumors). HCG levels are often tested in a woman who may have abnormal tissue growing in her uterus, a molar pregnancy, or a cancer in the uterus (choriocarcinoma) rather than a normal pregnancy. Several hCG tests may be done after a miscarriage to be sure a molar pregnancy is not present. In a man, hCG levels may be measured to help see whether he has cancer of the testicles. HCG in pregnancy An egg is normally fertilized by a sperm cell in a fallopian tube. Within nine days after fertilization , the fertilized egg moves down the fallopian tube into the uterus and attaches (implants) to the uterine wall. Once the fertilized egg implants, the developing placenta begins releasing hCG into your blood. Some hCG also gets passed in your urine. HCG can be found in the blood before the first missed menstrual period, as early as six days after implantation. HCG helps to maintain your pregnancy and affects the development of your baby (fetus). Levels of hCG increase steadily in the first 14 to 16 weeks following your last menstrual period (LMP), peak around the 14th week following your LMP, and then decrease gradually. The amount that hCG increases early in pregnancy can give information about your pregnancy and the health of your baby. Shortly after delivery, hCG can no longer be found in your blood. More hCG is released in a multiple pregnancy, such as twins or triplets, than in a single pregnancy. Less hCG is released if the fertilized egg implants in a place other than the uterus, such as in a fallopian tube. This is called an ectopic pregnancy.

hCG levels in urine Men: Nonpregnant women: Pregnant women: None (negative test) None (negative test) Detectable (positive test)

High values If you are pregnant, very high levels of human chorionic gonadotropin (hCG) can mean a multiple pregnancy (such as twins or triplets), a molar pregnancy, Down syndrome, or that you are further along in an early pregnancy than estimated by your last menstrual period (LMP). In a man or a nonpregnant woman, a high hCG level can mean a tumor (cancerous or noncancerous) that develops from a sperm or egg cell (germ cell tumor), such as a tumor of the testicles or ovaries, is present. It may also mean some types of cancer, such as cancer of the stomach, pancreas, large intestine, liver, or lung. Low values If you are pregnant, low levels of hCG can mean an ectopic pregnancy, death of your baby, or that you are not as far along in an early pregnancy as estimated by your last menstrual period (LMP). If you are pregnant, levels of hCG that are decreasing abnormally can mean amiscarriage (spontaneous abortion) is very likely. What Affects the Test Things that may affect the results of your test include:

Doing a urine test for human chorionic gonadotropin (hCG) very early in pregnancy (during the first week after implantation) or on a urine sample taken in the middle of the day. The test may not always show an early pregnancy. HCG results may remain high (positive) for up to four weeks after a miscarriage (spontaneous abortion) or therapeutic abortion. Getting an injection of hCG to treat infertility. This may cause test results to appear high for several days after the injection. Having blood in the urine sample or soap in the collecting container, which may change the hCG level. Using diuretics and promethazine. These medicines can cause false low hCG levels in urine test results. Using heparin, a medicine to prevent blood from clotting (anticoagulant). Using some medicines. These include hypnotics (such as Ambien), antipsychotics, and antinausea medicines (such as prochlorperazine and promethazine ). Be sure to tell your doctor what medicines you take.

http://www.webmd.com

Human Chorionic Gonadotropin (hCG): The Pregnancy Hormone

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The hormone human chorionic gonadotropin (better known as hCG) is produced during pregnancy. It is made by cells that form the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. Levels can first be detected by a blood test about 11 days after conception and about 12 - 14 days after conception by a urine test. In general the hCG levels will double every 72 hours. The level will reach its peak in the first 8 - 11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy.

Key things to remember about hCG levels:

In a bout 85% of normal pregnancies, the hCG level will double every 48 - 72 hours. As you get further along in pregnancy and the hCG level gets higher, the time it takes to double can increase to about every 96 hours.

Caution must be used in making too much of hCG numbers. A normal pregnancy may have low hCG levels and result in a perfectly healthy baby. The results from an ultrasound after 5 - 6 weeks gestation are much more accurate than using hCG numbers.

An hCG level of less than 5mIU/ml is considered negative for pregnancy, and anything above 25mIU/ml is considered positive for pregnancy. The hCG hormone is measured in milli-international units per milliliter (mIU/ml). A transvaginal ultrasound should be able to show at least a gestational sac once the hCG levels have reached between 1,000 - 2,000mIU/ml. Because levels can differentiate so much and conception dating can be wrong, a diagnosis should not be made by ultrasound findings until the hCG level has reached at least 2,000.

A single hCG reading is not enough information for most diagnoses. When there is a question regarding the health of the pregnancy, multiple testings of hCG done a couple of days apart give a more accurate assessment of the situation.

The hCG levels should not be used to date a pregnancy since these numbers can vary so widely. There are two common types of hCG tests. A qualitative hCG test detects if hCG is present in the blood. A quantitative hCG test (or beta hCG) measures the amount of hCG actually present in the blood.

Guideline to hCG levels during pregnancy:

hCG levels in weeks from LMP (gestational age)* :

3 weeks LMP: 5 - 50 mIU/ml 4 weeks LMP: 5 - 426 mIU/ml 5 weeks LMP: 18 - 7,340 mIU/ml 6 weeks LMP: 1,080 - 56,500 mIU/ml 7 - 8 weeks LMP: 7, 650 - 229,000 mIU/ml 9 - 12 weeks LMP: 25,700 - 288,000 mIU/ml 13 - 16 weeks LMP: 13,300 - 254,000 mIU/ml 17 - 24 weeks LMP: 4,060 - 165,400 mIU/ml 25 - 40 weeks LMP: 3,640 - 117,000 mIU/ml Non-pregnant females: <5.0 mIU/ml Postmenopausal females: <9.5 mIU/ml

* These numbers are just a GUIDELINE-- every womans level of hCG can rise differently. It is not necessarily the level that matters but rather the change in the level.

What can a low hCG level mean?

A low hCG level can mean any number of things and should be rechecked within 48-72 hours to see how the level is changing. A low hCG level could indicate:

Miscalculation of pregnancy dating Possible miscarriage or blighted ovum Ectopic pregnancy

What can a high hCG level mean?

A high level of hCG can also mean a number of things and should be rechecked within 48-72 hours to evaluate changes in the level. A high hCG level can indicate:

Miscalculation of pregnancy dating Molar pregnancy Multiple pregnancy

Should my hCG level be checked routinely?

It is not common for doctors to routinely check your hCG levels unless you are showing signs of a possible problem. A health care provider may recheck your levels if you are bleeding, experiencing severe cramping, or have a history of miscarriage.

What can I expect of my hCG levels after a pregnancy loss?

Most women can expect their levels to return to a non-pregnant range about 4 - 6 weeks after a pregnancy loss has occurred. This can differentiate by how the loss occurred (spontaneous miscarriage, D & C procedure, abortion, natural delivery) and how high the levels were at the

time of the loss. Health care providers usually will continue to test hCG levels after a pregnancy loss to ensure they return back to <5.0

Can anything interfere with my hCG levels?

Nothing should interfere with an hCG level except medications that contain hCG. These medications are often used in fertility treatments, and your health care provider should advise you on how they may affect a test. All other medications such as antibiotics, pain relievers, contraception or other hormone medications should not have any effect on a test that measures hCG.

http://www.americanpregnancy.org