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• Misnomer
- do not actually determine pregnancy,
but human chorionic gonadotrophin (hCG)
Radioimmunoass
ay
•Uses radioisotopes
•More sensitive and could use serum
•Not affected by LH as much
•Need special equipment to read
•Usually was done when early dx was
important
Immunoassay
Enzyme
Immunoassay
ELISA Kit
Immunoassay
Enzyme
Immunoassay
•Monoclonal Beta - HCG Enzyme Tests
•Very sensitive
•Can pick up .05 IU (1 week after
implantation)
• specificity is high because cross reaction
with
other hormones besides hCG is not a
Quantitative Pregnancy Testing
• Ectopic pregnancies low levels
• low levels in 1 st trimester = bad prognosis
• Trophoblastic Tumors
- Hydatiform Mole - benign grape-like mass
- Choriocarcinoma - may follow usual childbirth
or incomplete removal of hydatiform mole,
malignant
*Increased levels of up to 6,000,000 IU vs.
100,000 in normal pregnancy
• Increased HCG
-Seen in multiple pregnancies and
Eclampsia
-High levels HCG seen in males that have
testicular tumors
Home pregnancy test
Home pregnancy test
Neural tube defects include both spina bifida(improper closure of the fetal
spine) and anencephaly(improper closure of the fetal skull). Anencephaly is a
lethal condition.
Pap Smear Collection
Technique
Who should have a Pap smear?
• The American Cancer Society recommends that you
have your first Pap smear about three years after first
having sexual relations or at age 21. After age 21, the
guidelines are as follows:
Prior to Pap Smear:
Try to schedule your Pap smear when you are not menstruating. If
your cycle is unpredictable, and you start your period when it will
coincide with your appointment, call your doctor's office as soon as
possible to see if the doctor may recommend rescheduling.
To ensure that you get the most accurate results, it is recommended
that 48 hours before having a Pap smear you should not:
• have sex
• douche
• use tampons
• use spermicidal foams, creams, or inserts
• use vaginal creams or suppositories
PARENTAL
GUIDANCE
Padded Stirrups
• Soft, padded stirrups
• Oven mitts
• Socks
Inspect
• Spread labia
• Discharge
• Ulcers
• Growths
PARENTAL
GUIDANCE
Anatomy
PARENTAL
GUIDANCE
Vaginal Speculum
Warm Speculum
• Warm water
• Not too hot
• Lubricates speculum
• Don’t use K-Y,
Surgilube or Vaseline
to lubricate speculum
Insert Speculum
• Spread labia
• Keep labia apart
• Blades remain
closed until fully
inserted
PARENTAL
GUIDANCE
Squamo-Columnar Junction
• Insert ~ 2 cm (until
brush is fully inside
canal)
• Rotate only 180
degrees (otherwise will
cause bleeding)
Make Pap Smear
• As thin as possible
• Properly labeled
Spray with Fixative
• Within 10-15
seconds
• Allow to fully dry
before packaging
• Cytologic Fixative
(hairspray works
acceptably also)
Factors That Diminish the Accuracy of Pap Smears
EXFOLIATIVE CYTOLOGY
SUPERFICIAL CELLS
INTERMEDIATE CELLS
NAVICULAR CELLS
PARABASAL CELLS
ENDOCERVICAL CELLS
ENDOCERVICAL CELLS
LACTOBACILLI / COCCOBACILLI
GARDNERELLA VAGINALIS
(CLUE CELLS)
M 26
Candida spp.
Candida spp.
Leptothrix
ACTINOMYCES SPP.
M 27
TRICHOMONAS VAGINALIS
M 28
Herpes simplex
NORMAL
LSIL
LSIL
HSIL