Alternate Names: Beta-HCG - qualitative serum; Human chorionic gonadotrophin - qualitative serum; Pregnancy test - blood; Qualitative serum beta-HCG; Serum HCG

How Performed: Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Most pregnancy tests now use monoclonal antibodies to detect Beta-HCG in the blood sample.

How To Prepare: No special preparation is usually necessary.

How It Feels: When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Risks:

• excessive bleeding
• fainting or feeling lightheaded
• hematoma (blood accumulating under the skin)
• infection (a slight risk any time the skin is broken)
• multiple punctures to locate veins

Why Performed: Most often, this test is performed to confirm or rule out pregnancy. Serum HCG may also be increased in women with certain types of ovarian tumors or men with testicular tumors.

HCG, a hormone produced during pregnancy, is detectable in the blood or urine 1 to 2 days after implantation (10 days after ovulation). It increases rapidly in the first trimester, reaching a peak 60 to 80 days after fertilization; then drops off quickly to 10 to 30% of the peak value for the rest of the pregnancy. It serves to maintain progesterone production by the corpus luteum in the early part of pregnancy. By the time HCG drops at the beginning of the second trimester, the placenta can make sufficient progesterone to maintain the endometrium. HCG also stimulates the development of fetal gonads and synthesis of androgens by the fetal testes.

Normal Values: The test is negative if you are not pregnant.
The test is positive if you are pregnant.

Abnormal Results: Abnormal results may indicate:

• ectopic pregnancy
• spontaneous abortion (miscarriage)
• testicular cancer
• trophoblastic tumor

• abortion, threatened
• anovulatory bleeding
• first trimester pregnancy
• hydatidiform mole
• ovarian cancer
• ovarian cysts
• pelvic inflammatory disease (PID)
• polycystic ovarian disease (PCOD)

Cost:

Special Considerations: False positive tests may occur when certain hormones are increased (such as are present after menopause or when taking hormone supplements).

A pregnancy test is considered to be about 98% accurate. When the test is negative but pregnancy is still suspected, the test should be repeated in 1 week.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.