Explore the vast range of titles available.

In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) initiation. Understanding the characteristics of women who use pregnancy self-tests can facilitate more targeted efforts to improve pregnancy testing experiences and entry into the ANC pathway. We conducted a cross-sectional survey among pregnant women enrolling in a pre-exposure prophylaxis (PrEP) implementation study to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall, in our study population, 17% of women obtained a pregnancy self-test from a pharmacy. Pregnancy test use was higher among employed women, women with secondary and college-level educated partners, and women who spent 30 minutes or less traveling to the maternal and child health (MCH) clinic. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing as well as developing community-based models to improve access to pregnancy testing and ANC.

PurposeDetermine if the SPIKES method was associated with less distress and more compassion than current modes of delivering negative pregnancy test results to patients undergoing in vitro fertilization.MethodsTwenty-seven nurses from two centers were randomized to use the modified SPIKES script or continue their standard of care; 136 patients with a negative hCG following embryo transfer were included. SPIKES nurses received 1 h of training by a study psychologist; nurses in the control group were instructed to deliver the news as done previously. Patients who underwent embryo transfer and received a call by a participating nurse with a negative test result received an email invitation on the following day.ResultsControl patients reported significantly less distress than SPIKES patients; 33% of SPIKES patients reported that they had felt “extremely sad,” compared to 15.2% of the control patients (p = 0.01). Perceived compassion did not differ between the groups (all p ≥ 0.22).ConclusionPatients who received a negative pregnancy test result from the nurses who received a brief training and a script on how to deliver bad news via the modified SPIKES protocol reported significantly more distress than patients receiving negative results from nurses utilizing their standard of care. It is unclear whether a modified SPIKES method to deliver negative pregnancy test results will benefit patients undergoing in vitro fertilization.Trial registrationClinical trials.gov NCT04917445.

The aim of this study was to determine and compare the diagnostic accuracies of two commercial pregnancy‐associated glycoprotein tests, Alertys OnFarm Pregnancy Test (AOPT) and Alertys Milk Pregnancy Test (AMPT), for early pregnancy diagnosis in dairy cattle. Holstein cows (n = 124) were used in the study. Whole blood samples were collected from the jugular vein 28 days after fixed‐time artificial insemination (FTAI). In addition, teats of these cows were swabbed and milk samples were collected into sterile Falcon tubes. AOPT was performed on the farm within 2 h after whole blood collection. Milk samples for AMPT analysis were taken to the laboratory and analysed within 2 h. Transrectal ultrasonography was performed on the 32nd day after FTAI as a reference test. Comparative evaluation was made according to the AOPT and AMPT results, 28 days after FTAI. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the AOPT were 92.4%, 80.0%, 87.9%, 89.0% and 85.7% and for AMPT were 97.5%, 82.2%, 91.9%, 90.6% and 94.9% respectively. Cohen's kappa statistic showed a 91.9% agreement (kappa = 0.820, p < 0.001) between the reference test and AMPT, and an 87.9% agreement (kappa = 0.735, p < 0.001) between the reference test and AOPT. AOPT and AMPT offers a reliable, non‐invasive (in milk) and practical approach to pregnancy diagnosis in cows. These methods enable early pregnancy detection and can be easily integrated into farm routines, enhancing reproductive management and overall herd productivity. Early pregnancy diagnosis contributes to increasing productivity and profitability in dairy farms. The performance of AOPT and AMPT used for early pregnancy diagnosis in dairy cattle was evaluated for the first time together. AOPT and AMPT are practical methods for early pregnancy diagnosis, 28 days after insemination in dairy cows.

Reproductive management significantly impacts dairy farm productivity, necessitating accurate timely pregnancy detection in cattle. This paper presents a novel handheld and portable fluorescence imaging system designed for quantitative assessment of pregnancy-specific biomarkers, addressing the limitations of current detection methods. The objective was to develop a cost-effective, at-farm solution for detecting pregnancy-specific protein B (PSPB) in bovine plasma samples. The system integrates an imaging module and a custom software application, enabling image capture, data processing, and PSPB concentration determination. Calibration utilizing known PSPB concentrations achieved a 0.6 ng/mL limit of detection. Validation encompassed a comparison with a standard ELISA method using 100 bovine plasma samples; minimal bias and good agreement were observed within the linear range of the calibration curve for both methods. The system offers portability, user-friendliness, and potential for multiplex detection, promising real-time, at-farm reproductive management. This study demonstrates the successful development and validation of a portable fluorescence imaging system, offering an efficient and accurate approach to detecting pregnancy-specific biomarkers in cattle. Its implications extend to improving dairy farm productivity by enabling timely and reliable reproductive management practices.

Abstract Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59–1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14–0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.

Early pregnancy diagnosis in dairy cows is an important part of the production processes. Accurate early pregnancy diagnosis can help veterinarians identify open cow as soon as possible and carry out the second breeding earlier, which is of great significance for improving reproductive efficiency of dairy cow. In this study, a rapid immunochromatography based on latex microspheres for detecting pregnancy-related glycoprotein (PAG) was established with two monoclonal antibodies. The samples collected from 28 days after breeding of 559 Holstein cows were used to diagnose pregnancy. The results showed that the minimum detection limit of the established latex immunochromatography for PAG was 0.2 ng/mL. Compared to ultrasound, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of this method for pregnancy diagnosis was 99.25%, 90%, 91.03%, 99.15%, and 94.68%, respectively, and the kappa value is 0.89, which demonstrated that the pregnancy diagnosis results of the test strip method have high consistency with ultrasound. Compared with commercial enzyme-linked immunosorbent assay (ELISA) kits, the positive coincidence rate, negative coincidence rate, and overall coincidence rate of this method was 98.29%, 97.6%, and 98.03%, respectively. This indicated that the test strip has high consistency with the currently widely used ELISA immunological diagnostic method. The latex immunochromatographic method established in this study can accurately diagnose pregnant cows and can be used for early pregnancy diagnosis of dairy cows. The method is simple to operate and fast to detect, and the results are easy to interpret, which is of great significance and clinical application value for cow early pregnancy detection. Key points • A rapid immunochromatography based on latex microspheres with two monoclonal antibodies specific to PAG2 was established for early pregnancy diagnosis of dairy cows. • The early pregnancy test method, which we have developed, exhibits high sensitivity and can be utilized in small to medium-scale ranches. • The clinical sample test results demonstrated that the test strip has a high degree of consistency with ultrasound.

Background Early medical abortion (EMA) is safe and effective; an uncommon but crucial adverse outcome is ongoing live pregnancy. The best method of follow-up after EMA to detect ongoing pregnancy is a critical research gap. Few trials compare blood or urine pregnancy tests to ultrasound scans, and no trial compares these tests to each other. The aim is to evaluate the completeness of follow-up of two methods of follow-up after EMA— self-assessment with low-sensitivity urine pregnancy test result or serial serum βhCG blood tests. Secondary aims will evaluate whether self-assessment follow-up is safe and acceptable to patients and clinicians. Methods This is a multicentre randomised controlled trial in New Zealand. Eligible women and pregnant people having EMA will be randomised to self-assessment or blood test follow-up. The primary outcome is ‘lost to follow-up.’ To detect a decrease in ‘lost to follow-up’ rate from baseline of 15% to 7.5%, with 90% power and a two-sided type 1 error of 0.05, the sample size required is 736 participants, in a 1:1 ratio. Discussion If self-assessment reduces lost to follow-up, has additional clinical benefits, and is safe, cost-effective, and acceptable to women and clinicians, we anticipate change in EMA follow-up practice around the world. We think self-assessment will be welcomed as part of a patient-centred package of care following EMA. Trial registration This trial was prospectively registered with the Australia New Zealand Clinical Trials Registry (ANZCTR) on 21 August 2023, registration number ACTRN12623000890639; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384373

Transrectal ultrasonography is known as the gold standard for pregnancy detection, but requires costly equipment and technical skills; therefore, access to an inexpensive and more user-friendly method with similar accuracy could benefit cattle producers. Detection of pregnancy-associated glycoproteins can accurately determine pregnancy in ruminants; however, usually requires specialized equipment for the assay. Thus, the objectives of these studies were to 1) validate the IDEXX Alertys OnFarm Pregnancy Test (lateral flow) and compare the accuracy of all three commercial PAG assays to transrectal ultrasonography and 2) to determine the postpartum interval necessary for clearance of pregnancy-associated glycoproteins from the previous pregnancy to avoid false positives. In study 1, blood samples from previously identified pregnant Bos taurus females from six different herds (nulliparous n = 1,205 and multiparous n = 1,539; samples collected between d 27 to 285 of gestation over a three-year period) were utilized. In study 2, postpartum females (primiparous n = 48 and multiparous n = 66) from one herd were utilized: (n = 1,066; samples collected weekly for up to 12 weeks postpartum). In study 1, level of agreement between different methods of pregnancy detection was determined by Pearson’s correlation and Kappa scores. In study 2, data were analyzed as a repeated measure using the MIXED procedure of SAS with main effects of parity, days postpartum (dpp), and parity by days postpartum, then data were analyzed further using the REG procedure of SAS. In study 1, transrectal ultrasonography and lateral flow were positively correlated (r = 0.77; P <0.01), with 92.4% agreement. In study 2, the abundance of absorbance of PAGs rapidly decreased from 0 to 50 days postpartum, then continued to gradually decrease ( P <0.01; r = 0.90). Prior to 42 days postpartum, PAG concentrations were sufficiently elevated resulting in false positive readings in all assays. In conclusion, there is very good agreement between transrectal ultrasonography and PAG assays, but likelihood of false positive results are highif assays are performed fewer than 42 days postpartum.

Background In food production animals, especially cattle, the diagnosis of gestation is important because the timing of gestation directly affects the running of farms. Various methods have been used to detect gestation, but none of them are ideal because of problems with the timing of detection or the accuracy, simplicity, or cost of the method. A new method for detecting gestation, which involves assessing interferon-tau (IFNT)-stimulated gene expression in peripheral blood leukocytes (PBL), was recently proposed. PBL fractionation methods were used to examine whether the expression profiles of various PBL populations could be used as reliable diagnostic markers of bovine gestation. Methods PBL were collected on days 0 (just before artificial insemination), 7, 14, 17, 21, and 28 of gestation. The gene expression levels of the PBL were assessed with microarray analysis and/or quantitative real-time reverse transcription (q) PCR. PBL fractions were collected by flow cytometry or density gradient cell separation using Histopaque 1083 or Ficoll-Conray solutions. The expression levels of four IFNT-stimulated genes, interferon-stimulated protein 15 kDa ( ISG15 ), myxovirus-resistance ( MX ) 1 and 2 , and 2′-5′-oligoadenylate synthetase ( OAS1 ), were then analyzed in each fraction through day 28 of gestation using qPCR. Results Microarray analysis detected 72 and 28 genes in whole PBL that were significantly higher on days 14 and 21 of gestation, respectively, than on day 0. The upregulated genes included IFNT-stimulated genes. The expression levels of these genes increased with the progression of gestation until day 21. In flow cytometry experiments, on day 14 the expression levels of all of the genes were significantly higher in the granulocyte fraction than in the other fractions. Their expression gradually decreased through day 28 of gestation. Strong correlations were observed between the expression levels of the four genes in the granulocyte fractions obtained with flow cytometry and with density gradient separation. Conclusions The expression profiles of ISG15 , MX1 , MX2 , and OAS1 could be a useful diagnostic biomarker of bovine gestation. Assessing the expression levels of these genes in a granulocyte fraction obtained with density gradient separation is a practical way of detecting gestation in cows within three weeks of insemination.

Medical abortion with mifepristone and prostaglandins is well established. We compared clinical assessment with self-assessment of abortion outcome. This randomised, controlled, non-inferiority trial was done in four clinics in Austria, Finland, Norway, and Sweden, between Aug 16, 2011, and Jan 31, 2013. Women aged 18 years and older who had requested medical termination of a pregnancy up to 63 days of gestation were eligible. Computer-generated block randomisation (block size ten) assigned women in a 1:1 ratio to attend routine clinical follow-up or to self-assess outcome at home with a semiquantitative urine human chorionic gonadotropin (hCG) test 1–3 weeks after abortion. The primary outcome was the percentage of women with complete abortion not requiring further medical or surgical intervention within 3 months. Analysis was per protocol and by intention to treat. The non-inferiority margin was five percentage points. This trial is registered with ClinicalTrials.gov, number NCT01487213. 924 women were assigned routine follow-up (n=466) or self-assessment (n=458) and included in the intention-to-treat analysis. 901 were included in the per-protocol analysis (n=446 and n=455, respectively). Complete abortion was reported in 432 (95%) of 455 in the routine follow-up group and 419 (94%) of 446 women in the self-assessment group (crude difference −1·0, 95% CI −4·0 to 2·0). 20 (4%) women in the routine follow-up group and 17 (4%) in the self-assessment group required surgery. No women in the routine follow-up group versus three in the self-assessment group had undetected continuing pregnancies. Eight (1·8%) and one (0·2%) women, respectively, had infections (p=0·038). Self-assessment was non-inferior to routine follow-up and could save resources. Nordic Federation of Obstetrics and Gynaecology, European Society of Contraception, Helsinki University Central Hospital, Helse Finnmark, Swedish Research Council, and Stockholm County Council and Karolinska University Hospital.