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How do i know im not pregnant


CDC - How To Be Reasonably Certain a Woman Is Not Pregnant - US SPR

In most cases, a detailed history provides the most accurate assessment of pregnancy risk in a woman who is about to start using a contraceptive method. Several criteria for assessing pregnancy risk are listed in the recommendation that follows. These criteria are highly accurate (i.e., a negative predictive value of 99%–100%) in ruling out pregnancy among women who are not pregnant (16–19). Therefore, CDC recommends that health care providers use these criteria to assess pregnancy status in a woman who is about to start using contraceptives (Box 2). If a woman meets one of these criteria (and therefore the health care provider can be reasonably certain that she is not pregnant), a urine pregnancy test might be considered in addition to these criteria (based on clinical judgment), bearing in mind the limitations of the accuracy of pregnancy testing. If a woman does not meet any of these criteria, then the health care provider cannot be reasonably certain that she is not pregnant, even with a negative pregnancy test. Routine pregnancy testing for every woman is not necessary.


BOX 2. How to be reasonably certain that a woman is not pregnant

A health care provider can be reasonably certain that a woman is not pregnant if she has no symptoms or signs of pregnancy and meets any one of the following criteria:

  • is ≤7 days after the start of normal menses
  • has not had sexual intercourse since the start of last normal menses
  • has been correctly and consistently using a reliable method of contraception
  • is ≤7 days after spontaneous or induced abortion
  • is within 4 weeks postpartum
  • is fully or nearly fully breastfeeding (exclusively breastfeeding or the vast majority [≥85%] of feeds are breastfeeds), amenorrheic, and <6 months postpartum

On the basis of clinical judgment, health care providers might consider the addition of a urine pregnancy test; however, they should be aware of the limitations, including accuracy of the test relative to the time of last sexual intercourse, recent delivery, or spontaneous or induced abortion. Routine pregnancy testing for every woman is not necessary. If a woman has had recent (i.e., within the last 5 days) unprotected sexual intercourse, consider offering emergency contraception (either a Cu-IUD or ECPs), if pregnancy is not desired.

Comments and Evidence Summary. The criteria for determining whether a woman is pregnant depend on the assurance that she has not ovulated within a certain amount of time after her last menses, spontaneous or induced abortion, or delivery. Among menstruating women, the timing of ovulation can vary widely. During an average 28-day cycle, ovulation generally occurs during days 9–20 (20). In addition, the likelihood of ovulation is low from days 1–7 of the menstrual cycle (21). After a spontaneous or an induced abortion, ovulation can occur within 2–3 weeks and has been found to occur as early as 8–13 days after the end of the pregnancy. Therefore, the likelihood of ovulation is low ≤7 days after an abortion (22–24). A systematic review reported that the mean day of first ovulation among postpartum nonlactating women occurred 45–94 days after delivery (25). In one study, the earliest ovulation was reported at 25 days after delivery. Among women who are within 6 months postpartum, are fully or nearly fully breastfeeding (exclusively breastfeeding or the vast majority [≥85%] of feeds are breastfeeds), and are amenorrheic, the risk for pregnancy is <2% (26,27).

Although pregnancy tests often are performed before initiating contraception, the accuracy of qualitative urine pregnancy tests varies depending on the timing of the test relative to missed menses, recent sexual intercourse, or recent pregnancy. The sensitivity of a pregnancy test is defined as the concentration of human chorionic gonadotropin (hCG) at which 95% of tests are positive. Most qualitative pregnancy tests approved by the U.S. Food and Drug Administration (FDA) report a sensitivity of 20–25 mIU/mL in urine (28–31). However, pregnancy detection rates can vary widely because of differences in test sensitivity and the timing of testing relative to missed menses (30,32). Some studies have shown that an additional 11 days past the day of expected menses are needed to detect 100% of pregnancies using qualitative tests (29). In addition, pregnancy tests cannot detect a pregnancy resulting from recent sexual intercourse. Qualitative tests also might have positive results for several weeks after termination of pregnancy because hCG can be present for several weeks after delivery or abortion (spontaneous or induced) (33–35).

For contraceptive methods other than IUDs, the benefits of starting to use a contraceptive method likely exceed any risk, even in situations in which the health care provider is uncertain whether the woman is pregnant. Therefore, the health care provider can consider having patients start using contraceptive methods other than IUDs at any time, with a follow-up pregnancy test in 2–4 weeks. The risks of not starting to use contraception should be weighed against the risks of initiating contraception use in a woman who might be already pregnant. Most studies have shown no increased risk for adverse outcomes, including congenital anomalies or neonatal or infant death, among infants exposed in utero to COCs (36–38). Studies also have shown no increased risk for neonatal or infant death or developmental abnormalities among infants exposed in utero to DMPA (37,39,40).

In contrast, for women who want to begin using an IUD (Cu-IUD or LNG-IUD), in situations in which the health care provider is uncertain whether the woman is pregnant, the woman should be provided with another contraceptive method to use until the health care provider is reasonably certain that she is not pregnant and can insert the IUD. Pregnancies among women with IUDs are at higher risk for complications such as spontaneous abortion, septic abortion, preterm delivery, and chorioamnionitis (41).

A systematic review identified four analyses of data from three diagnostic accuracy studies that evaluated the performance of the criteria listed above through use of a pregnancy checklist compared with a urine pregnancy test conducted concurrently (42). The performance of the checklist to diagnose or exclude pregnancy varied, with sensitivity of 55%–100% and specificity of 39%–89%. The negative predictive value was consistent across studies at 99%–100%; the pregnancy checklist correctly ruled out women who were not pregnant. One of the studies assessed the added usefulness of signs and symptoms of pregnancy and found that these criteria did not substantially improve the performance of the pregnancy checklist, although the number of women with signs and symptoms was small (16) (Level of evidence: Diagnostic accuracy studies, fair, direct).

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False Pregnancy (Pseudocyesis): Causes, Symptoms, and Tests

Written by Stephanie Watson

In this Article

  • What Causes False Pregnancy?
  • Symptoms of False Pregnancy
  • Tests for False Pregnancy
  • Treating False Pregnancy

Pregnancy is usually an exciting time for expectant parents. But pregnancy doesn't always end with the anticipated baby. In rare cases, women (or even men) believe they are pregnant, only to find out that their symptoms were caused not by pregnancy, but by something else entirely.

False pregnancy, clinically termed pseudocyesis, is the belief that you are expecting a baby when you are not really carrying a child. People with pseudocyesis have many, if not all, symptoms of pregnancy -- with the exception of an actual fetus. Some men experience a related phenomenon known as couvade, or sympathetic pregnancy. They will develop many of the same symptoms as their pregnant partners, including weight gain, nausea, and backache.

 

What Causes False Pregnancy?

Only recently have doctors begun to understand the psychological and physical issues that are at the root of pseudocyesis. Although the exact causes still aren't known, doctors suspect that psychological factors may trick the body into "thinking" that it's pregnant.

When a woman feels an intense desire to get pregnant, which may be because of infertility, repeat miscarriages, impending menopause, or a desire to get married, their body may produce some pregnancy signs (such as a swollen belly, enlarged breasts, and even the sensation of fetal movement). The woman's brain then misinterprets those signals as pregnancy, and triggers the release of hormones (such as estrogen and prolactin) that lead to actual pregnancy symptoms.

Some researchers have suggested that poverty, a lack of education, childhood sexual abuse, or relationship problems might play a role in triggering false pregnancy. Having a false pregnancy is not the same as claiming to be pregnant for a benefit (for example, to profit financially), or having delusions of pregnancy (such as in patients with schizophrenia).

 

Symptoms of False Pregnancy

Women with pseudocyesis have many of the same symptoms as those who are actually pregnant, including:

  • Interruption of the menstrual period
  • Swollen belly
  • Enlarged and tender breasts, changes in the nipples, and possibly milk production
  • Feeling of fetal movements
  • Nausea and vomiting
  • Weight gain

These symptoms can last for just a few weeks, for nine months, or even for several years. A very small percentage of patients with false pregnancy will arrive at the doctor's office or hospital with what feels like labor pains.

Tests for False Pregnancy

To determine whether a woman is experiencing a false pregnancy, the doctor will usually evaluate their symptoms, perform a pelvic exam and abdominal ultrasound -- the same tests used to feel and visualize the unborn baby during a normal pregnancy.

In a case of false pregnancy, no baby will be seen on the ultrasound, and there won't be any heartbeat. Sometimes, however, the doctor will find some of the physical changes that occur during pregnancy, such as an enlarged uterus and softened cervix. Urine pregnancy tests will always be negative in these cases, with the exception of rare cancers that produce similar hormones to pregnancy.

Certain medical conditions can mimic the symptoms of pregnancy, including ectopic pregnancy, morbid obesity, and cancer. These conditions may need to be ruled out with tests.

Treating False Pregnancy

When women believe they are pregnant, especially for a period of several months, it can be very upsetting for them to learn that they are not. Doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from their disappointment.

How to determine pregnancy without a test

How to determine pregnancy without a test and what signs indirectly indicate that your beloved baby will be born soon? Of course, only a blood test can give a 100% guarantee, but the presence of certain signs may indicate its possible onset.

Classic signs of pregnancy

The most common early signs and symptoms may include

  • Delayed menses. nine0011 Problems with the regularity of the menstrual cycle may be associated with hormonal imbalance in the body. But if the delay arose for the first time, and before that the cycle was as accurate as a clock, then it is likely that you are pregnant.
  • Early toxicosis with severe nausea and vomiting - the most common sign of an interesting situation, but not every woman has.
  • Pain in both breasts or enlargement. Nipples can become very sensitive and change color. Sometimes in the early stages, colostrum is released from them with slight pressure. nine0012
  • Pain in the pelvic region, similar to menstruation. But this sign can also indicate such a serious pathology as an ectopic pregnancy.
  • Increased amount of discharge from the genitals. This can usually be observed during ovulation. Normal discharge is clear and odorless. When a whitish tint or a curdled structure appears, thrush can also be assumed, which is a common problem for expectant mothers. But in this case, you can not do without treatment. During the period of bearing a child, it is necessary to protect your body as much as possible from any, even such a safe disease. nine0012
  • Increased or vice versa reduced libido. Every woman experiences jumps in sexual desire in one direction or the other due to hormonal changes occurring in the body. Therefore, men should treat this with understanding, knowing that they have not become less loved, but these are just signs of pregnancy.
  • Frequent urination, despite the fact that you do not drink more often and there are no inflammatory diseases of the genitourinary system. A similar phenomenon is associated with a slight relaxation of the sphincter of the bladder due to hormonal processes. And with the growth of the uterus and, accordingly, with the increase in pressure on the bladder, going to the toilet will become even more frequent. nine0012

Additional symptoms of pregnancy

There are less obvious signs that may occur during the first trimester. These include:

  • Strange Desires . For example, at night I sharply wanted chocolate, and during the day - salted fish. Such desires may not be mere whims. If you want sour, then perhaps there is not enough vitamin C in the body. You want to gnaw on the wall with calcium deficiency, and sniff gasoline - with a lack of iron, anemia. nine0012
  • Constant irritability, tearfulness. The flow of hormones in a woman's body in the early stages can make her unusually emotional. So-called mood swings can be a clear sign of pregnancy.
  • Bloating . Hormonal changes can cause feelings of fullness in the abdomen, as at the beginning of the menstrual cycle.
  • Bloody discharge pale pink. This symptom is called implantation bleeding. This happens when a fertilized egg attaches to the lining of the uterus, about 10 to 14 days after conception. Usually occurs during the normal periods of the menstrual period. But not all women have such bleeding is a sign of a normal pregnancy. Therefore, in case of detection of deviations from the normal cycle, consult a gynecologist. nine0012
  • Chair problems . Hormonal changes cause the digestive system to slow down, which can lead to constipation.
  • Food aversions . When you are pregnant, you may become more sensitive to certain smells and your sense of taste may change. Like most other symptoms, these eating habits can be attributed to hormonal changes.
  • Nasal congestion . An increase in hormone levels and blood production can lead to swelling of the nasal mucosa. This can cause congestion or runny nose, nosebleeds. nine0012

How to recognize pregnancy in the early stages. Infographics | infographic

AiF

Very often, pregnancy becomes a surprise, both for the woman herself and for her environment. Some, on the contrary, plan a pregnancy for a long time and listen to all the changes in their body, sometimes wishful thinking. Our infographic will tell you how to accurately determine pregnancy in the early stages. nine0003

Symptoms of pregnancy

Well, of course, based on symptoms alone, it is impossible to accurately determine pregnancy. Although they may suggest doing a test. Let's consider the main symptoms in more detail:

1. Sensitive chest. Already a few days after conception, a pregnant woman may notice the first changes. Nipples become more sensitive than usual. This also applies to the rest of the chest. But not always sensitive breasts are a sign of pregnancy. Similar sensations can occur during ovulation or before menstruation. nine0003

2. Delayed menses. One of the main signs indicating pregnancy, but not 100 percent. Perhaps you are experiencing climate change, hormonal failure, or gynecological diseases. This is a serious symptom and it is better to consult a doctor. However, a delay of no more than five days is considered the norm. It can also happen that you are pregnant, but your period continues to go. Here you can only advise: after unprotected intercourse, listen to your body and take a pregnancy test. nine0003

3. Frequent urination. Is one of the symptoms of pregnancy. But it can also be a symptom of illness, hypothermia, stress, etc.

4. Darkening of the areola of the nipples. Occurs usually no earlier than two weeks later. However, darkening can be caused by the influence of sex hormones in a non-pregnant woman.

5. Increased salivation. Usually appears with nausea in the first three months of pregnancy. Also, salivation is a characteristic symptom in almost all diseases of the oral cavity, gastrointestinal tract, and even with inflammation of the trigeminal nerve. nine0003

Types of tests

Any symptom characteristic of pregnancy may be a harbinger of a disease. Therefore, you need to listen to your body, but on the basis of symptoms alone, you should not diagnose yourself. Moreover, medicine has long allowed women to determine pregnancy with an accuracy of up to 100%. For a more effective result in the early stages, you can donate blood for the pregnancy hormone hCG (chorionic gonadotropin). Every day of pregnancy, the amount of this hormone in the body increases, but at very early stages only very sensitive tests can catch it. Pregnancy can be determined by the level of hCG in the blood within a few days after conception. nine0003

If for one reason or another you cannot go to a medical institution, then home tests will help. Of course, a few days after conception, such a test will not show anything. All tests for the determination of hCG in the urine should be done no earlier than a week before the onset of menstruation. The cheapest test strips will show a valid result only from the first day of delay. More expensive tests - inkjet or tablet, can determine pregnancy just a week before critical days. In general, in order not to guess on coffee grounds - is it too early to take a test, or is it time already - you need to know some values. Such home tests have a sensitivity of 10 to 25 Mme/ml. So the smaller the number, the more sensitive the test. For example, a ten test can show pregnancy as early as four weeks. What a week you can have is easy to calculate, you need to remember the first day of your last menstruation - this will be the starting point. nine0003

Test results

Any pregnancy test can show both a false positive and a false negative result. False-negative results are associated, as a rule, with incorrect testing, violation of the instructions. Or too short a pregnancy. It may be that the second band is weakly expressed. This is possible if you took the test before the expected delay, or if you have an ectopic pregnancy. False positive test results are rare, but possible. It can occur due to taking medications containing hCG, tumors, a recent miscarriage, etc. nine0003

Ultrasound will show the most accurate result. It will confirm pregnancy and help rule out an ectopic. You can do it no earlier than 3. 5-4 weeks after conception. If you do not know when the conception occurred, then you can count about 5-6 weeks from the beginning of the last menstruation. Before this time, there is no point in going to the ultrasound. It is better to consult a gynecologist, and he will prescribe the necessary examinations in the early stages of pregnancy.

See also:

  • Seven ways to strengthen the immune system. Tips from a Stavropol doctor →
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