The NACB laboratory medicine practice guidelines for point of care reproductive testing

Octavia M. Palmer, David G. Grenache, Ann M. Gronowski

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Although only a limited number of point-of-care tests for reproduction-related markers are available, they are widely used in both health care and home environments. These types of tests include urine tests for the assessment of pregnancy status, urine (biochemical) and nonurine (bioelectric) measurements for the detection and prediction of ovulation, ferning and pH tests to determine amniotic membrane rupture, and fetal fibronectin testing for predicting preterm delivery. Practice guidelines and recommendations for these and other point-of-care tests have been established by the National Academy of Clinical Biochemistry. The lack of evidence to support the use of these tests is striking. Either there are no studies investigating the clinical use of many of these tests or there is lack of sufficient evidence to support their intended use. Urine pregnancy tests are commonly performed, yet it is unknown if they actually improve outcomes, and their diagnostic accuracy has not been reported for over a decade. Although urine tests for luteinizing hormone are capable of detecting and predicting ovulation, it is unknown if they actually improve conception rates. The clinical usefulness of tests of membrane status is uncertain, and their performance is acceptable only when membrane status is actually known. As a test for predicting preterm delivery, fetal fibronectin is an excellent indicator of women who are unlikely to deliver within 7 days of testing, yet there is insufficient evidence to demonstrate that it can improve outcomes. Well-designed investigations are required to establish the evidence necessary to support the clinical use of these often used point-of-care tests.

Original languageEnglish
Pages (from-to)265-272
Number of pages8
JournalPoint of Care
Volume6
Issue number4
DOIs
StatePublished - Dec 1 2007

Keywords

  • Luteinizing hormone
  • Nitrazine
  • Point-of-care tests
  • Pregnancy
  • fFN
  • hCG

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