Quando la futura mamma ha il dubbio di una gravidanza, la cosa più ovvia e più frequente è l’uso dei così detti “test di gravidanza”. I test immediati, quelli cioè che si acquistano in farmacia o al supermercato, sono basati sull’individuazione della gonadotropina corionica (HCG) nelle urine. Questo è un ormone prodotto dal trofoblasto, un tessuto che si trasformerà successivamente nella placenta, intorno al 21-22° giorno del ciclo (tali numeri corrispondo solo ad un ciclo regolare con ovulazione al 14° giorno).
Sono costituiti da uno stick di plastica con all’interno una striscia reattiva alla gonadotropina corionica. Per rilevare la presenza della gonadotropina è sufficiente esporre lo stick al flusso di urina e dopo pochi minuti, si è in grado di leggere la quantità di ormone e quindi determinare se l’esito è positivo o no. I test standard danno una risposta con le linee rosa: 2 linee test positivo (si è incinte), 1 linea test negativo (ritenta!). I test di ultima generazione “parlano”: incinta si, incinta no e addirittura danno indicazioni sul numero di giorni in cui si è gravide. Alcuni sono addirittura in grado di rilevare la presenza dell’HCG a partire da 8 giorni dopo l’ovulazione, solitamente vengono venduti in confezioni da due in modo da poter confermare l’esito dopo qualche giorno.
Fin qui tutto più o meno semplice. Chiaramente si fa per dire. Chi cerca un figlio in quei giorni non capisce più niente e non è raro che si acquistino più test non convinti del risultato del primo.
Io non sono da meno: con Supernano sono arrivata a quota 3! Il primo debolmente positivo non mi aveva convinto, il secondo negativo mi ha fatto sprofondare nello sconforto, il 3° dopo qualche giorno ancora debolmente positivo mi ha fatto concludere che era meglio buttare tutto e attendere. Cosa? Il ritorno dalle vacanze… va bè, io sono fatta così, molto fatalista sono partita pensando che al ritorno me ne sarei preoccupata (comunque a mia discolpa devo dire che la mia ginecologa era anche lei in ferie e mai e poi mai sarei andata da qualcun altro!). A settembre il test non era più necessario e neppure il dosaggio delle beta HCG. Supernano era lì, più vispo che mai. E se ci penso, ancora mi sgorga qualche lacrimuccia…….
Ah….con microba è stato diverso: subito 2 belle linee fucsia che non lasciavano adito ad alcun dubbio!
Non sempre, purtroppo, tutto va così liscio. Innanzitutto i casi di falsi negativi non sono così rari, perchè talvolta la concentrazioni di gonadotropina nelle prime settimane di gravidanza non è sufficiente per far reagire la striscia. I falsi positivi invece sono legati alla presenza di gonadotropina derivante da stati patologici.
In casi di esiti dubbi o qualora non sia certa la datazione della gravidanza talora viene consigliato l’esame che rileva la concentrazione di gonadotropina corionica (BHCG) nel sangue. Il dosaggio in realtà andrebbe eseguito solo in casi selezionati, ad esempio quando si sospetta una gravidanza extrauterina. Infatti, in questa situazione, le beta sono superiori a 1000-1500 U/L, ma in utero non si visualizza la camera gestazionale. Negli altri casi, l’esecuzione su larga scala delle beta HCG crea solo confusione ed ansia, spesso immotivata. Infatti se il ginecologo ha a disposizione un ecografo con sonda transvaginale dosare le beta HCG non serve praticamente a niente. È il caso purtroppo di alcuni aborti: il ginecologo verifica l’assenza del battito, ma le beta e sono in aumento; questo perché le beta sono prodotte dalla placenta, pertanto anche in caso di aborto si possono osservare valori stabili oppure in rialzo (ma non in raddoppio ogni due giorni).
Posto qui una tabella con le settimane di gravidanza e i valori di riferimento delle beta HCG:
|
beta – HCG |
VALORI DI RIFERIMENTO |
UNITÀ DI MISURA |
| Non in gravidanza | ASSENTE | mUI/mL |
| 3 – 4 settimana | 9 – 130 | |
| 4 – 5 settimana | 75 – 2.600 | |
| 5 – 6 settimana | 850 – 20.800 | |
| 6 – 7 settimana | 4.000 – 100.200 | |
| 7 – 12 settimana | 11.500 – 289.000 | |
| 12 – 16 settimana | 18.300 – 137.000 | |
| 16 – 29 settimana | 1.400 – 53.000 | |
| Secondo trimestre | ||
| 29 – 41 settimana | 940 – 60.000 |
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