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Ann Gronowski, Ph.D.
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Early in 2017, the American Thyroid Association (ATA) issued new guidelines for the diagnosis and management of thyroid diseases during pregnancy and the postpartum. This 74 page document covers everything from thyroid function testing during pregnancy, to thyroid autoantibodies and pregnancy complications and thyroid disease and lactation. It is a... Continue reading
Posted Dec 4, 2017 at The Pregnancy Lab
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Direct-to-consumer (DTC) laboratory testing permits consumers to order laboratory tests directly from a clinical laboratory without necessarily having to work with their healthcare provider. Currently nearly 40 states allow consumers to order some or all of their laboratory tests. This model of lab testing is relatively new in the United... Continue reading
Posted Oct 26, 2017 at The Pregnancy Lab
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We have previously blogged about testing for Zika virus in pregnant women here and here. But testing recommendations continue to evolve. As a result of increasing knowledge about the Zika virus, the CDC updated their recommendations. The changes are based on declining trends in the number of reported cases of... Continue reading
Posted Oct 2, 2017 at The Pregnancy Lab
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We have blogged previously about the ongoing debate regarding the treatment of subclinical hypothyroidism in pregnancy (here and here). In brief, there was a study published in 1999 that demonstrated that 7-9 year old children, from women with abnormal thyroid measurements during pregnancy, performed slightly less well than the control... Continue reading
Posted Sep 11, 2017 at The Pregnancy Lab
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Last week, at the annual meeting of the American Association for Clinical Chemistry (AACC) we heard an impressive presentation by Dr. Teresa Woodruff PhD on “Oncofertility.” Although the topic is a bit removed from laboratory testing, I thought it was still an important topic for this blog. So what is... Continue reading
Posted Aug 14, 2017 at The Pregnancy Lab
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Preeclampsia occurs in 5 to 8% of pregnancies and is a major contributor of premature deliveries and neonatal morbidity in the U.S. and worldwide. It is characterized by new onset hypertension and proteinuria after 20 weeks of gestation and delivery is currently the only treatment. Because the etiology of preeclampsia... Continue reading
Posted Apr 24, 2017 at The Pregnancy Lab
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We have previously blogged about Zika virus during pregnancy.That post was in February of 2016 and a lot has changed since then. For one thing, Zika has been shown to be transmitted via sexual contact from an infected individual (even if he or she does not have symptoms) to a... Continue reading
Posted Feb 20, 2017 at The Pregnancy Lab
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We have blogged previously about the limitations of urine hCG tests to detect pregnancy in a hospital setting and about the Abbott iSTAT, the first FDA approved device for detection of hCG in whole blood at the point-of-care. Recently, Nerenz et al evaluated the NOWDiagnostics ADEXUSDx™ hCG test, a qualitative... Continue reading
Posted Feb 6, 2017 at The Pregnancy Lab
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Premature rupture of membranes (PROM) is spontaneous rupture of fetal membranes before the onset of uterine contractions. Preterm PROM, which is PROM before 37 weeks is a major cause of preterm birth. Previously, we have blogged about the cervicovaginal markers IGFBP1 and AFP to diagnose PROM. In recent years, a... Continue reading
Posted Aug 9, 2016 at The Pregnancy Lab
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Zika virus is a mosquito borne illness that is found in South and Central America. The most common symptoms include fever, rash, joint pain, and conjunctivitis (red eyes). The virus is spread by mosquitos primarily in the Aedes aegypti and Aedes albopictus species which also carry other tropical diseases such... Continue reading
Posted Feb 15, 2016 at The Pregnancy Lab
We have blogged previously (here and here) about false negative results in qualitative point-of-care (POC) hCG devices due to high concentrations of hCGβcf in urine. We have shown that the majority of qualitative POC hCG devices are actually susceptible to false negative results due to saturation of capture antibodies by... Continue reading
Posted Jan 19, 2016 at The Pregnancy Lab
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“How early can pregnancy be detected?” is a question we are asked all the time. The short answer is, “It depends.” Let’s answer this question one step at a time. First, the most common way to detect early pregnancy is by measuring the hormone human chorionic gonadotropin (hCG). If an... Continue reading
Posted Oct 26, 2015 at The Pregnancy Lab
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In the past, we have blogged about false negative urine qualitative hCG tests in both point-of-care (POC) hospital devices and over-the-counter (OTC) devices due to the presence of high concentrations of hCGbcf. We feel this represents a real problem for patients and clinicians trying to diagnose pregnancy and could results... Continue reading
Posted Oct 3, 2014 at The Pregnancy Lab
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Preimplantation genetic testing is a way of examining the genetic features of a developing embryo during the process of in vitro fertilization, before pregnancy. After the egg is fertilized with sperm, the embryos develop to the cleavage-stage. On day 3 after fertilization, a single blastomere is removed from the embryo... Continue reading
Posted Mar 5, 2014 at The Pregnancy Lab
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In previous blog posts we have discussed false negative urine hCG tests due to high concentrations of hCG beta core fragment (hCGβcf), the predominant form of hCG found in urine after six weeks of pregnancy. High concentrations of hCGβcf saturate either one or both of the antibodies used in the... Continue reading
Posted Feb 12, 2014 at The Pregnancy Lab
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If you are interested in hCG, like we are, you might be interested in a recent paper, in Clinical Chemistry, by Dr. Glenn Braunstein entitled "The long gestation of the modern home pregnancy test." Dr. Braunstein is one of the researchers that helped develop the first radioimmunoassay specific for hCG... Continue reading
Posted Jan 15, 2014 at The Pregnancy Lab
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We have blogged in the past about false negative pregnancy tests due to hCG beta core fragment (hCGbcf). After about 5 weeks of pregnancy (i.e. 3 weeks after the expected period) concentrations of hCGbcf, in urine, are higher than all other forms of hCG. Our group has shown previously that... Continue reading
Posted Sep 18, 2013 at The Pregnancy Lab
Recently, we blogged about a paper by Kyle & Lawrence that demonstrated poor precision of the lamellar body counts (LBC) using the Coulter Unicel DxH 800 instrument. Now we want to make you aware of a study by Beaudoin and others that demonstrates a bias in LBCs between the Sysmex... Continue reading
Posted Aug 21, 2013 at The Pregnancy Lab
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Point of care devices which detect luteinizing hormone (LH) are used to predict ovulation and time intercourse in women who are trying to get pregnant. Women attending fertility clinics also commonly use these devices to time intrauterine insemination. Although the hormones LH and hCG share 80% structural homology, cross reactivity... Continue reading
Posted Jul 31, 2013 at The Pregnancy Lab
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What are my chances of getting pregnant? More specifically, if I am having trouble getting pregnant, will I be successful if I undergo the process of in vitro fertilization (IVF)? These are important questions especially since infertility treatments (especially IVF) is time consuming and costly. There are tools to assess... Continue reading
Posted Jul 17, 2013 at The Pregnancy Lab
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David has blogged in the past about the diagnosis of gestational diabetes mellitus (GDM). In July 2012 he discussed a debate that was underway among experts regarding newly proposed diagnostic guidelines. Just to recapitulate the debate, for at least 10 years we have been diagnosing GDM with a two-step process.... Continue reading
Posted Apr 25, 2013 at The Pregnancy Lab
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In the last several years, there have been a lot of articles in both the popular press and the scientific literature about Vitamin D. There are studies that report that low concentrations of vitamin D are associated with everything from cancer to multiple sclerosis and asthma to cardiovascular disease. There... Continue reading
Posted Mar 20, 2013 at The Pregnancy Lab
There is a saying in science that every 10 or 20 years scientists "reinvent" things. This refers to observations someone made and published, but the findings were largely ignored for 10-20 years until a new scientist comes along and makes the same or similar observation and suddenly everyone takes notice.... Continue reading
Posted Dec 28, 2012 at The Pregnancy Lab
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In September 2011, The American Thyroid Association (ATA) published new guidelines on the diagnosis and management of thyroid disease during pregnancy and postpartum. There are many recommendations in the guidelines, but I wanted to highlight one in particular. Recommendation 2 "If trimester-specific reference ranges for TSH are not available in... Continue reading
Posted Aug 29, 2012 at The Pregnancy Lab
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The short answer is no, but let me explain why. Iodine is necessary for the production of the thyroid hormones T3 and T4. A deficiency of iodine leads to decreased production of these hormones and can cause goiter (enlargement of the thyroid) and hypothyroidism. During pregnancy, a number of normal... Continue reading
Posted Jun 25, 2012 at The Pregnancy Lab