Human Chorionic Gonadotropin
Qualitative analysis of urine levels of human chorionic gonadotropin (hCG) allows for detection of pregnancy as early as 10 days after a missed menstrual period. Production of hCG, a glycoprotein, which prevents degeneration of the corpus luteum at the end of the normal menstrual cycle, begins after conception. During the first trimester, hCG levels rise steadily and rapidly, peaking around the 10th week of gestation, subsequently tapering off to less than 10% of peak levels.
The most common method of evaluating hCG in urine is hemagglutination inhibition. This laboratory procedure can provide both qualitative and quantitative information. The qualitative urine test is easier and less expensive than the serum hCG test (beta-subunit assay); therefore, it's used more frequently to detect pregnancy.
Procedure and posttest care
In quantitative analysis, urine hCG levels in the first trimester of a normal pregnancy may be as high as 500,000 IU/24 hours; in the second trimester, they range from 10,000 to 25,000 IU/24 hours; and in the third trimester, from 5,000 to 15,000 IU/ 24 hours.
Measurable hCG levels don't normally appear in the urine of men or non-pregnant women.
During pregnancy, elevated urine hCG levels may indicate multiple pregnancy or erythroblastosis fetalis; depressed urine hCG levels may indicate threatened abortion or ectopic pregnancy.
Measurable levels of hCG in males and nonpregnant females may indicate choriocarcinoma, ovarian or testicular tumors, melanoma, multiple myeloma, or gastric, hepatic, pancreatic, or breast cancer.
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