ArticleJournal of obstetrics and gynaecology of India2025
Non-Invasive Estimation of Haemoglobin in Pregnancy: Assessing Accuracy and the Effect of Skin Pigmentation.
Article in Journal of obstetrics and gynaecology of India, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the accuracy of a non-invasive device to measure haemoglobin and compare it with the laboratory gold standard in pregnant women, and to assess if the results vary by skin pigmentation. Material and Methods: Women attending pre-operative assessment before a scheduled caesarean section were invited, and informed consent was taken. Haemoglobin (Hb) estimation was performed using a non-invasive point-of-care device (Masimo Pronto pulse co-oximeter). Venous blood sample was collected for full blood count. The skin pigmentation was classified using the Fitzpatrick scale. Bias and 95% limits of agreement were examined for haemoglobin estimation. Accuracy of the pulse co-oximeter device was assessed in the six Fitzpatrick scales of skin tone. Results: A total of 122 women were recruited. Twelve of these women (9.8%) had their haemoglobin values < 105 g/L. The Pronto device showed a significant positive bias. The mean difference was 23.4 (SD: 11.97) g/L. The 95% limits of agreement were - 0.06 to 46.9 g/L. The difference between the two methods was unrelated to the skin pigmentation. The area under the ROC curve was 0.705 (95% CI: 0.817-0.593, Conclusions: The point-of-care device (Masimo Pronto pulse co-oximeter) overestimates the Hb readings in pregnant women, and a correction is needed to estimate the real Hb value. The accuracy is unaffected by skin pigmentation. The device may be a potentially useful screening tool in the detection of anaemia in pregnancy in limited resource setting, but the 95% limits of agreements are relatively wide.
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