Abstract：
Point-of-care haemoglobin measurement devices may play an important role in the antenatal detection of anaemia in pregnant people and may be useful in guiding blood transfusion during resuscitation in obstetric haemorrhage. We compared baseline haemoglobin variability of venous and capillary HemoCue® haemoglobin, and Masimo® Rad-67 Pulse CO-Oximeter haemoglobin with laboratory haemoglobin in people on the day of their planned vaginal birth. A total of 180 people undergoing planned vaginal birth were enrolled in this prospective observational study. Laboratory haemoglobin was compared with HemoCue and Masimo Rad-67 Pulse CO-Oximeter measurements using Bland-Altman analysis, calculating mean difference (bias) and limits of agreement. Five (2.8%) people had anaemia (haemoglobin < 110 g.l-1 ). Laboratory haemoglobin and HemoCue venous haemoglobin comparison showed an acceptable bias (SD) 0.7 (7.54) g.l-1 (95%CI -0.43-1.79), with limits of agreement -14.10-15.46 g.l-1 and acceptable agreement range of 29.6 g.l-1 . Laboratory and HemoCue capillary haemoglobin comparison showed an unacceptable bias (SD) 13.3 (14.12) g.l-1 (95%CI 11.17-15.34), with limits of agreement - 14.42-40.93 g.l-1 and unacceptable agreement range of 55.3 g.l-1 . Laboratory and Masimo haemoglobin comparison showed an unacceptable bias (SD) -14.0 (11.15) g.l-1 (95%CI -15.63 to -12.34), with limits of agreement to -35.85 to 7.87 g.l-1 and acceptable agreement range of 43.7 g.l-1 . Venous HemoCue, with its acceptable bias and limits of agreement, should be applied more widely in the antenatal setting to detect, manage and risk stratify pregnant people with anaemia. HemoCue capillary measurement under-estimated haemoglobin and Masimo haemoglobin measurement over-estimated, limiting their clinical use. Serial studies are needed to determine if the accuracy of venous HemoCue haemoglobin measurement is sustained in other obstetric settings.
摘要：
即时血红蛋白测量设备可能在孕妇贫血的产前检测中起重要作用，并且可能有助于指导产科出血复苏期间的输血。我们比较了静脉和毛细血管HemoCue®血红蛋白的基线血红蛋白变异性，和Masimo®Rad-67PulseCO-Oximeter血红蛋白与实验室血红蛋白在计划的阴道分娩当天的人。这项前瞻性观察研究共招募了180名计划阴道分娩的人。使用Bland-Altman分析将实验室血红蛋白与HemoCue和MasimoRad-67脉冲CO血氧仪测量进行比较。计算平均差(偏差)和协议极限。5人（2.8％）患有贫血（血红蛋白<110g。l-1).实验室血红蛋白和血流量静脉血红蛋白比较显示可接受的偏倚（SD）0.7（7.54）g.l-1（95CI-0.43-1.79），协议限值-14.10-15.46g。l-1和29.6g的可接受协议范围。l-1.实验室和HemoCue毛细血管血红蛋白比较显示不可接受的偏倚（SD）13.3（14.12）g.l-1（95CI11.17-15.34），有协议限制-14.42-40.93克。l-1和55.3g的不可接受的协议范围。l-1.实验室和Masimo血红蛋白比较显示出不可接受的偏倚（SD）-14.0（11.15）g.l-1（95CI-15.63至-12.34），协议限值为-35.85至7.87g。l-1和43.7g的可接受协议范围。l-1.静脉血流图,以其可接受的偏见和协议的局限性，应该在产前环境中更广泛地应用于检测，管理和风险分层孕妇贫血。HemoCue毛细血管测量低估血红蛋白和Masimo血红蛋白测量高估，限制其临床使用。需要进行系列研究以确定在其他产科设置中静脉血红蛋白测量的准确性是否持续。
