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Pregnancy: Sensitivity and Specificity

Introduction: None written.

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Tags: None. Tag this Diagnosis.

The sensitivity and specificity of findings for Pregnancy are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Serum beta-hCG Edit 97%100%

as compared to urine beta hCG, for all comers to an ED for whom pregnancy tests were ordered. In this study, urine beta hCG had sens = 100%, spec = 99.2%

Study: Am J Emerg Med. 1993 Jul;11(4):434-6. PMID: 8216535

Specific Findings

Finding SensitivitySpecificity Comments, Study
Chadwick Sign Edit 51%98%

Only 1 study from Dr Chadwick. Sign is "characteristic" deep violet-blue color of anterior vaginal wall. Rarely seen before 7 weeks.

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Palpable Fundus Edit 9%97%

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Vaginal Exam Signs Edit 18%94%

not explicitly defined

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Uterine Artery Pulsation Edit 76%93%

only 1 study

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Morning Sickness Edit 39%85%

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Urine beta-hCG
Duplicate Edit
Sensitivity = 97%

7 days after missed period. Most urine b-hCG tests are sensitive to 20 mIU/ml. If sensitivity is at 0.5 mIU/ml then should be sensitive by 7 days after fertilization.

Study: JAMA 2001 Oct 10;286(14):1759-61. PMID 11594902

Urine beta-hCG
Duplicate Edit
Sensitivity = 90%

on 1st day of missed period. Most urine b-hCG tests are sensitive to 20 mIU/ml. If sensitivity is at 0.5 mIU/ml then should be sensitive by 7 days after fertilization.

Study: JAMA 2001 Oct 10;286(14):1759-61. PMID 11594902

Did Not Use Birth Control Edit 88%42%

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Breast Signs on Exam Edit 56%79%

not specifically defined

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Any Pregnancy Symptoms Edit 50%79%

morning sickness, breast tenderness / fullness, urinary frequency, or fatigue

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Patient Thinks She is Pregnant Edit 78%63%

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Delayed Menses Edit 67%41%

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Home Pregnancy Test Edit Sensitivity = 75%

Sens = 75% when used by actual patients but up to 91% when used by volunteers. Specificity not assessed but should be very high (~99%).

Study: Arch Fam Med 1998 Sep-Oct;7(5):465-9. PMID 9755740

Findings With Unspecified Accuracy

Finding SensitivitySpecificity Comments, Study
Goodell's Sign Edit No accuracy specified.

softening of the cervix, may be detected by 8 weeks of age

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Hegar's Sign Edit No accuracy specified.

Softening of the lower portion of the corpus of the uterus. May be seen by 6 weeks.

Study: JAMA. 1997 Aug 20;278(7):586-91. PMID: 9268281

Trans-Vaginal Ultrasound Edit No accuracy specified.

Gestational sac by 4.5-5 weeks, double decidual sign by 5.5-6 weeks, yolk sac by 5-6 weeks, cardiac activity by 5.5-6 weeks. Trans-abdominal ultrasound would be less sensitive for these findings.

Study: UpToDate

http://www.utdol.com/online/content/topic.do?topicKey=antenatl/22517