Assessing the viability of a blastosyst is still empirical and non-reproducible nowadays. We developed an algorithm based on artificial vision and machine learning (and other classifiers) that predicts pregnancy using the beta human chorionic gonadotropin (b-hCG) test from both the morphology of an embryo and the age of the patients. We employed two high-quality databases with known pregnancy outcomes (n = 221). We created a system consisting of different classifiers that is feed with novel morphometric features extracted from the digital micrographs, along with other non-morphometric data to predict pregnancy. It was evaluated using five different classifiers: probabilistic bayesian, Support Vector Machines (SVM), deep neural network, decision tree, and Random Forest (RF), using a k-fold cross validation to assess the model's generalization capabilities. In the database A, the SVM classifier achieved an F1 score of 0.74, and AUC of 0.77. In the database B the RF classifier obtained a F1 score of 0.71, and AUC of 0.75. Our results suggest that the system is able to predict a positive pregnancy test from a single digital image, offering a novel approach with the advantages of using a small database, being highly adaptable to different laboratory settings, and easy integration into clinical practice.

A positive urine pregnancy test was obtained in the emergency department on the night of admission. The patient was certain that she was not pregnant, which was confirmed by a negative serum pregnancy test.


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Laboratory investigations included urinalysis and urine culture, blood cultures, a complete blood count (CBC), a complete metabolic panel, lipase, amylase, and pregnancy testing. Computed tomography (CT) imaging of the abdomen and pelvis was performed. Her white blood cell (WBC) count was raised (17.6109/L), but her remaining blood test results were within normal limits. Blood cultures were negative, but urine cultures were positive for Proteus mirabilis species. CT imaging of the abdomen showed a left-sided staghorn calculus resulting in partial ureteric obstruction leading to hydronephrosis (Figure 1). Given her mildly increased temperature, leukocytosis, and clinical symptoms, the patient was diagnosed with pyelonephritis and was initially treated empirically on ceftriaxone, due to her prior history of susceptibility to Proteus infection.

Abdominal computed tomography (CT) imaging in a 28-year-old woman with tubal ligation and obstructive pyelonephritis due to renal calculus with a falsepositive urine pregnancy test. Abdomen CT imaging shows a left-sided staghorn calculus resulting in partial ureteric obstruction and hydronephrosis.

When a pregnancy test result is suspected to be a false-positive, lung cancer is the most common non-gestational malignancy known to be associated with ectopic beta-hCG production [3]. Congenital anomalies of kidney and urinary tract that require treatment with enteroplasty are also associated with false-positive test results, possibly associated with the presence of excess amounts of acidic mucin production in enteroplasty reservoir of these patients [12]. Also, adenomyosis is a condition that is associated with hemoglobinuria and has been reported to have an association with a false-positive test [13]. The false-positive findings in a patient with metastatic melanoma raised the possibility that beta-hCG may be a biomarker for monitoring treatment response in patients with melanoma [14]. Selvaraj et al. described a case in which a patient treated with the SSRI, escitalopram, had a false-positive urinary pregnancy test [15]. SSRI antidepressants are frequently prescribed, and so recognition of the association with false-positive pregnancy testing is an important factor for patients and physicians to be aware of [15].

In nephrotic syndrome, proteinuria can lead to a false-positive pregnancy test, depending on the quantity and quality of protein in the urine [5,17]. Usually, patients need to have a 4+ proteinuria to have a false-positive urine pregnancy test, and in this clinical setting, a serum pregnancy test would be advised [17]. Proteinuria in patients with nephrotic syndrome can be due to rheumatoid factor in the urine and can result in a false-positive pregnancy test result [16], [20,21]. In the perimenopausal and postmenopausal woman, the pituitary gland may produce hCG in low levels, and false-positive pregnancy test in this patient population may be an assumed to indicate malignancy, when none exists [19]. Red blood cell transfusion from a pregnant woman has also been reported to result in the passive transfer of beta-hCG, resulting in a false-positive pregnancy test [18].

Healthcare professionals should be aware of the physiologic situations that have the potential to lead to false-positive urine pregnancy test results. In this case report, the patient had a false-positive urine pregnancy test, which led to a delay in diagnostic imaging and urologic treatment. The results of a serum test were required before definitive treatment could begin. However, awareness of the conditions associated with a false urine pregnancy test might help speed up the process of obtaining a definitive serum result. Furthermore, in some populations, a false-positive urine pregnancy test might result in further unnecessary invasive diagnostic tests to identify a malignant etiology.

Uploaded at-home urine pregnancy tests from case 4. A, C, Two of the photographs were identical but cropped to different dimensions. B, When asked to resubmit, the patient digitally inserted the date to the same image.

Uploaded at-home urine pregnancy tests from case 5. A, The first uploaded photograph is identical to (B) the second uploaded photograph, albeit in different image resolution.

Uploaded at-home urine pregnancy tests from case 7. A, The first uploaded image is a digital stock photograph. B, The second uploaded image is also a digital stock photograph and is positive for pregnancy.

In patients with epigastric pain, simultaneous amylase and lipase measurements are recommended because an elevated lipase level with a normal amylase level is not likely to be caused by pancreatitis.13 Liver chemistries are important in patients with right upper quadrant pain. A urinalysis should be obtained in patients with hematuria, dysuria, or flank pain. A urine pregnancy test should be performed in women of childbearing age who have abdominal pain to narrow the differential diagnosis and to determine whether certain imaging studies are appropriate. Testing for chlamydia and gonorrhea is recommended for women at risk of sexually transmitted infections.

If ectopic pregnancy is suspected, transvaginal ultrasonography should be performed. The sensitivity of transvaginal ultrasonography for detecting ectopic pregnancy is 95 percent in a patient with a positive pregnancy test (human chorionic gonadotropin level greater than 25 mIU per mL [25 IU per L]) and any abnormal ultrasound finding, whereas a negative pregnancy test and normal ultrasound findings virtually exclude ectopic pregnancy.19 Transvaginal ultrasonography is also helpful for diagnosing other gynecologic pathology, such as fibroids, ovarian masses, ovarian torsions, and tuboovarian abscesses.

Abdominal pain in women may be related to pathology in the pelvic organs. Ovarian cysts, uterine fibroids, tuboovarian abscesses, and endometriosis are common causes of lower abdominal pain in women. In women of reproductive age, special attention to pregnancy, including ectopic pregnancy, and loss of pregnancy is critical in forming an appropriate differential diagnosis. The possibility of pregnancy modifies the likelihood of disease and significantly changes the diagnostic approach (e.g., avoidance of radiation exposure in diagnostic testing).

Natalist Pregnancy Test Strips detect human Chorionic Gonadotropin (hCG), one of the first signs of pregnancy, in urine and are over 99% accurate* when used correctly. In fact, clinical evaluations have shown that the test is more than 99% accurate from the day of your expected period.

*When used up to three days before your expected period. Early on in pregnancy, you may not be producing enough hCG for the test to detect. hCG hormone levels soar in early pregnancy, doubling about every two days. The more hCG your body makes, the more likely you are to get a positive result.

It can feel overwhelming after a positive pregnancy test, and you may be unsure of what to do next. We are here to help you through this and to give you all the information you need to make an informed decision regarding your unplanned pregnancy.

Ultrasounds also help safeguard your health and safety. By assessing the images provided by an ultrasound, you will receive important information. Limited ultrasounds may disclose the location of your pregnancy and ensure it is taking place in the uterus.

After a positive pregnancy test and an ultrasound confirming pregnancy, it is time to consider your options. Whether you are considering parenting, adoption, or abortion, our staff at My Life Clinic is here to provide accurate and updated information about your options.

First, congratulations!

 

The most common time to have a first appointment is around eight weeks gestation or about a month after that first missed period and positive pregnancy test. That said, many pregnant people should be seen earlier than that. For instance, people with diabetes, high blood pressure, history of ectopic pregnancy, who are on medications that might need to be changed, or who have bleeding or pain should be seen earlier. We also understand fully how brutal that month can be mentally, so if we can shorten that time and get people in sooner, we bend over backward to do it, even if we have to get creative!

 

It's always nice when the same doctor or team is able to follow a pregnancy all the way through, but there is always the freedom to change. In fact, sometimes a switch is needed for one of many reasons. When people change locations or offices during pregnancy, records go with them, so most testing doesn't have to be repeated, but there is always some redundancy while getting established. 

 

Many things happen at the first visit. We get to know each other, make sure the medical record is up to date, do a physical exam, update the Pap smear when appropriate, get blood work, talk about genetic testing options and check on the pregnancy itself. Whether an ultrasound is done at that appointment depends on gestational age and a few other factors, but we always check on the baby. 2351a5e196

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