Efficacy Evaluation of Using Finger-Stick Peripheral Blood for Point-of-Care Pregnancy Testing

Point of care (POC) pregnancy tests are designed for use with a urine specimen. However, the timely collection of a urine specimen is solely dependent on the patient's need or ability to urinate which can delay the initiation of care. A prior study has demonstrated high sensitivity for pre-collected blood (95.8%) as a viable alternative specimen for use with POC pregnancy test cartridges in comparison to urine (95.3%). The purpose of this study is to evaluate the efficacy of using peripheral finger stick blood for POC pregnancy testing.

This is an Institutional Review Board (IRB) approved research study. A convenience sampling of ultrasound confirmed first-trimester pregnant patients was enrolled from an OB/GYN clinic. Each participant provided 1-2 drops (100 microliters) of blood via a finger puncture collection using a lancet. The blood was placed into the specimen port of a QuPID+ POC pregnancy test cartridge, followed by 1-2 drops of sterile saline. The results were interpreted within 5 minutes. A 10-month review of one Midwest level-1 emergency department’s (ED) door-to-room time was conducted comparing average times for patients with and without POC pregnancy test orders. The data was analyzed using an unpaired t-test.

30 subjects were enrolled in the study with all subjects still within their first trimester (mean=61.4 days) based on ultrasound examination. The QuPID+ test results using peripheral blood had a 100% agreement with the positive ultrasound results. Over a 10-month period, the average ED door-to-room time for patients without a POC pregnancy test order was shorter compared to patients with POC pregnancy test orders (29.7 vs 48.7 minutes, p<0.0001, CI: 95%), indicating a 64% longer wait time for patients with POC pregnancy test orders.

A patient’s pregnancy status is critical to their ED acuity and room assignment. If their pregnancy status is unknown, it can result in delays in their care. This study supports the use of peripheral blood as a viable alternative to urine for POC pregnancy testing. Being able to rapidly obtain pregnancy test results using peripheral blood instead of a urine or venipuncture specimen can reduce patient door-to-room time thus improving throughput as well as patient and provider satisfaction.