Lab Logic: Using hCG testing in pregnancy and beyond
Robert C. Erigo-Backman RN
Cathy R. Kessenich DSN, ARNP

$3.95 		The Nurse Practitioner: The American Journal of Primary Health Care
May 2012 
Volume 37  Number 5
Pages 18 - 19
 
  PDF Version Available!

ABSTRACT
Mrs. C is a 29-year-old female who is generally healthy. Over the past 4 weeks, she has experienced abdominal cramping, constipation, nausea, and fatigue. Due to her gastrointestinal symptoms and fatigue, Mrs. C believed she had a problem with her gastrointestinal tract and made an appointment to see her nurse practitioner (NP).During a review of her medical history, Mrs. C states that she can now sleep 9 to 11 hours per night, which is atypical for her. She is married and has two children ages 6 and 8. Nine months ago, she and her husband decided he should undergo a vasectomy because she is intolerant of hormonal contraceptives. His surgery was uneventful and they have had periodic intercourse without additional contraception since that time. Her last menstrual period was 6 weeks ago. Her last Pap smear was 2 years ago and the results were normal. Upon exam Mrs. C seems fatigued and agrees to a breast, abdominal, and pelvic exam during the appointment. Mrs. C's breast exam is normal with the exception of tenderness with deep palpation bilaterally. Her abdominal exam was normal. Her genitalia exam revealed pink vaginal walls with rugae, and a positive Chadwick sign, Goodell sign, and Hegar sign.1After completing Mrs. C's medical history and physical exam, the NP ordered several tests to assist in the differential diagnosis. A complete blood cell count was ordered to check for anemia (due to the fatigue), and a urine human chorionic gonadotropin (hCG) was conducted in the office. The urine sample tested positive for pregnancy. A serum hCG test was also obtained and sent to the lab, and the results were positive for pregnancy. Mrs. C was referred to an obstetrical provider for prenatal education and care.hCG is a glycoprotein hormone that is a part of a family of hormones which includes luteinizing hormone (LH), follicle-stimulating hormone, and thyroid stimulating hormone. The hCG hormone is composed of an alpha subunit and beta-subunit joined noncovalently.2 Four variants

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