Implementing a point-of-care test for β-human chorionic gonadotropin testing within an abortion service

There are several scenarios within abortion care in which the measurement of serum beta-human chorionic gonadotropin (β-hCG) levels is useful or necessary. These include the management of pregnancy of unknown location, diagnosis of miscarriage or gestational trophoblastic disease, and confirmation that a medical abortion is complete as part of the protocol for very early medical abortion (VEMA).1–4 In NHS Lothian (Edinburgh and surrounding region), the abortion service based in Chalmers Sexual Health Centre provides abortion for approximately 3500 patients per year and operates a telemedicine-based service.5 6 Patients can also have an in-person consultation, with or without an ultrasound scan, if preferred or indicated. As is the case for many community services across the UK, there is no laboratory on site, which means that any serum β-hCG samples require transportation to the Royal Infirmary of Edinburgh for testing. Samples sent from mid-morning onwards will likely not have results available until the following day. This inevitable delay in serum β-hCG results means that medical staff working in the abortion service may not be readily available to interpret them. In addition, it can cause delays in management plans and associated worry for the patient. The availability of quantitative point-of-care tests (POCTs) provides an opportunity for improving care to those attending abortion services who require β-hCG testing. Highly accurate POCTs for β-hCG now mean that results are available within minutes rather than hours and that clinicians who can interpret these results are still available on site. The patient pathways for the two types of test are illustrated in figure 1. Figure 1 Patient pathways for the two modes of beta-human chorionic gonadotropin (β-hCG) testing. POCT, point-of-care test. A β-hCG POCT (Easy Reader, VEDALAB) was previously piloted among women presenting to our abortion service …