From the Guidelines
It is recommended to get a pregnancy test in person at the doctor's when you experience missed menses, irregular bleeding, new onset of irregular bleeding after prolonged amenorrhea, new onset pelvic pain, or an enlarged uterus or adnexal mass on examination, as outlined in the guidelines for primary care management of persons infected with human immunodeficiency virus 1. When considering a pregnancy test, it's essential to evaluate the situation based on the most recent and highest quality evidence. The guidelines from 2009 suggest that pregnancy testing should be considered in specific situations, including missed menses, irregular bleeding, and new onset pelvic pain 1.
- Key situations that warrant a pregnancy test in person at the doctor's include:
- Missed menses, unless using certain contraceptive methods like etonorgestrel implants or depot medroxyprogesterone acetate
- Irregular bleeding, unless using certain contraceptive methods like etonorgestrel implants or depot medroxyprogesterone acetate
- New onset of irregular bleeding after prolonged amenorrhea while using certain contraceptive methods
- New onset pelvic pain
- Enlarged uterus or adnexal mass on examination
- Before institution of new medications with potential adverse effects for the pregnant woman or fetus
- At the patient's request In addition to these situations, a doctor's visit for a pregnancy test can provide an opportunity for early prenatal care, necessary screenings, and lifestyle recommendations to support a healthy pregnancy, as suggested by the recommendations for providing quality family planning services 1. It's also important to note that while routine pregnancy testing for every woman is not necessary, as stated in the U.S. selected practice recommendations for contraceptive use, 2013 1, a doctor's visit can help determine the best course of action for individual cases. Ultimately, getting a pregnancy test in person at the doctor's is crucial in situations where there are potential health risks or complications, and the doctor can provide guidance and care to support the best possible outcome.
From the Research
When to Get a Pregnancy Test in Person at the Doctor's
It is recommended to get a pregnancy test in person at the doctor's in the following situations:
- If a woman of childbearing age is experiencing symptoms such as pelvic or abdominal pain, amenorrhoea, missed period or abnormal period, and vaginal bleeding 2, 3, 4
- If a woman has risk factors for ectopic pregnancy, such as previous ectopic pregnancy, PID, endometriosis, previous pelvic surgery, the presence of a coil, and infertility 2, 3, 4
- If a woman is haemodynamically unstable or has significant concern about the degree of pain or bleeding, she should be referred directly to A&E, irrespective of the result of the pregnancy test 2
- If a stable patient has bleeding and pain, or a pregnancy of six weeks gestation or more, or a pregnancy of uncertain gestation, she should be referred immediately to an early pregnancy assessment (EPA) service, or out-of-hours gynaecology service if the EPA service is not available 2
- If a woman has a positive pregnancy test and is experiencing symptoms such as syncope, or hypotension, a work-up to detect possible ectopic or ruptured ectopic pregnancy should be performed 3
Key Symptoms and Signs
Key symptoms and signs that may indicate the need for a pregnancy test in person at the doctor's include:
- Pelvic or abdominal pain
- Amenorrhoea, missed period or abnormal period
- Vaginal bleeding
- Syncope, or hypotension
- Adnexal or cervical motion tenderness
- Rebound tenderness and abdominal distension 2, 3, 4
Diagnostic Tests
Diagnostic tests that may be used to confirm a pregnancy and detect possible ectopic or ruptured ectopic pregnancy include: