151: The accuracy of noninvasive hemoglobin assessment in an obstetric population

Abstract

assessment in an obstetric population Sharon Cooley, Marie Bourke, Roger McMorrow, Fionnuala McAuliffe Rotunda Hospital, Obstetrics and Gynecology, Dublin, Ireland, National Maternity Hospital, UCD School of Medicine and Medical Sciences, Dublin 2, Ireland, National Maternity Hospital, Department of Anaesthesia, Dublin 2, Ireland, UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, Dublin, Ireland OBJECTIVE: To validate continuous and non-invasive hemoglobin assessment in an obstetric setting, and to compare the values with traditional laboratory measurements of hemoglobin. STUDY DESIGN: Ethical approval was obtained and participants were recruited from the antenatal clinic of the National Maternity Hospital at the time of phlebotomy for their standard antenatal laboratory hemoglobin estimation. Hemoglobin was measured using the Sysmex XE-2100 automated haematology analyser (Sysmex Corporation, Sysmex Europe GmbH, Norderstedt, Germany). The SpHb Pulse CoOximeter was calibrated and the probe attached to the index finger of the patients hand. The mean of three non-invasive measurements of hemoglobin was recorded over 5 minutes. Maternal age, gestation, medical history, medications, body mass index and blood pressure were also recorded. Data analysis was undertaken using the Statistical Package for the Social Sciences (SPSS), Version 15.0. Bland Altman plots were used to determine acceptability of the new non-invasive test as a replacement for invasive testing in a clinical setting. RESULTS: In total 125 women were recruited and two women were excluded as their laboratory hemoglobin tests had to be repeated due to sampling error. The mean maternal age of the participants was 31.7 years. The mean gestation was 20.8 (8.6) weeks. Laboratory hemoglobin values ranged from 8.8 to 15.1 g/dL with a mean of 12.1 (1.0) g/dL. The range for the SpHb Pulse Co-Oximeter assessment was 9.1 to 15.8g/dL with a mean of 12.6 (1.3) g/dL. The Bland Altman plot for the two tests (Figure) illustrates the acceptable accuracy of haemoglobin assessment with the noninvasive method. CONCLUSION: Non-invasive hemoglobin measurement proved accurate compared to traditional hemoglobin testing and may offer a rapid cheap acceptable alternative to invasive testing in obstetric clinical scenarios. 152 Perinatal outcome of induction of labor compared with expectant management for term twin pregnancy Soo Hyeon Moon, Eun-Na Kim, Seung Chul Kim, Jong Kwan Jun Pusan National University School of Medicine, Department of Obstetrics and Gynecology, Busan, Korea, Seoul National University College of Medicine, Obstetrics and Gynecology, Seoul, Korea, Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul, Korea OBJECTIVE: It was reported that maternal complications such as cesarean section rate, chorioamnionitis, and uterine atony are increased in induction of labor in singleton pregnancies. The purpose of this study was to evaluate the risk of induction of labor in term twin pregnancy. STUDY DESIGN: We conducted a retrospective study of 479 term twin pregnancies between January 1999 and June 2011. Perinatal outcomes of induction of labor for term twin pregnancies (n 377) were compared with term twin pregnancies with spontaneous labor (n 102). Outcome criteria are cesarean section rate, chorioamnionitis, uterine atony, Apgar score at 5 minutes, umbilical artery pH 7.2, and the rate of NICU admission. RESULTS: The average gestational age at delivery in the induction group was significantly later than that in the expectant management group (38.25 0.69, 37.94 0.72 weeks, p 0,001). There were no significant differences in maternal and neonatal outcome between the two groups (Table). CONCLUSION: In the term twin pregnancy, induction of labor does not increase the maternal and neonatal complication. For the term twin pregnant women suffering from overdistended uterus, induction of labor is a reasonable approach without additional maternal and neonatal risk. www.AJOG.org Clinical Obstetrics, Medical-Surgical-Disease, Neonatology, Physiology-Endocrinology Poster Session I