Case Story: Faster point-of-care hCG testing, transforming patient management in emergency gynaecology unit, reducing patient anxiety

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Fast point-of-care hCG testing

The introduction of rapid, point-of-care hCG testing has transformed the management of problems in early pregnancy at The Royal London Hospital’s Emergency Gynaecology Unit (EGU) in Whitechapel. A busy outpatient service, the EGU provides tertiary care services to women who experience pain or bleeding in the early stages of pregnancy.

The EGU has recently acquired an AQT90 FLEX system from Radiometer, which has led to a new strategy for dealing with inconclusive sonography results. Parvesh Mohan, Senior Nurse Practitioner in the EGU, explained: “Although our clinical investigation is predominantly sonography-based, quantitative analysis of ß-hCG is an invaluable additional tool for the management of problems in early pregnancy, particularly when the results of an ultrasound scan are uncertain.

“Historically, we have had to rely on sending blood results to the hospital laboratory for analysis, usually receiving the results within two to three hours. This is not ideal from a patient management point of view, as patients usually have to leave the unit and come back either a few hours later or even the following day. The need to schedule extra appointments not only places additional demands on our resources, it can also create a great deal of anxiety for the patient.”

Reliable, user-friendly system

“Just over a year ago we became aware of a newly-launched point-of-care ß-hCG analysis instrument – Radiometer’s AQT90 FLEX – which would allow us to perform rapid testing within the clinic. Because we are not laboratory personnel, we needed a reliable, user-friendly system that allowed us to simply put a bottle in and get a result out, and the AQT90 FLEX is perfect for this. It is a robust system that is very easy to use, allowing us to load our samples onto the platform then continue with our patient care. It is also fully enclosed, virtually eliminating the risk of staff coming into contact with blood, and the controls are very intuitive.”

Transforming patient management

Dr Mary Gbegbaje, who leads the EGU, added: “Point-of-care testing has transformed the way we manage pregnancies of uncertain location. Where previously we would have to send patients away following an inconclusive scan, we are now able to get the results of the test while the patient is still in the clinic, allowing us to clarify the situation and arrange a second scan immediately if necessary.

“This rapid analysis is also particularly important for women who have an empty uterus and an adnexal mass – as would be expected for an ectopic pregnancy – allowing us to decide on the spot whether to refer the patient for surgery or to manage their condition expectantly or medically. The AQT90 FLEX provides fast, reliable results for a majority of our patients requiring ß-hCG analysis. This enables us to initiate a management plan without delay, which is very good for the patient, making it a real asset to the EGU.”

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