Urine Pregnancy and False Negatives - Low SG
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We have numerous clinics using lateral flow Urine Pregnancy Testing, SureVue. Results are manually entered into EPIC via enter/edit. Recently, we have had a few concerns raised about false negative results on urines that have been dilute and not first morning sample. Procedurally, we have these sample typed identified as a limitation. We all understand that at the POC setting we get the urine sample that the patient can provide at time of testing. How are you all addressing the dilute urine testing that can result in false negatives?
Thanks in advance!
Erika Deaton-Mohney
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We recommend either repeating later or do a Lab serum HCG. They should also take into consideration the full clinical picture and physical exam.
Kathy Andrews
MLT, RT
Point of Care Coordinator /
Coordinatrice des Analyses Hors Laboratoire
Moncton & Miramichi Area /
Régions de Moncton et Miramichi
Horizon Health Network / Reseau de Sante Horizon
Tel: (506)-857-5315 Fax: (506) 857-5325
kathy.andrews@horizonnb.ca
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From: Erika Deaton-Mohney BS, MT(ASCP), CPP via POCT Listserv (Groupsite)
[mailto:users+1166739@poct.groupsite.com]
Sent: October-23-19 11:24 AM
To: Andrews, Kathy (LAB) (HorizonNB)
Subject: [POCT Listserv] Urine Pregnancy and False Negatives - Low SG
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Have you considered the high-dose hook effect? All lateral-flow urine tests can give a false negative if the hCG is very high. We warn users that this can happen as early as 6-8 weeks after conception.
We have considered the hook effect. The kit we are using has the hook effect not interfering until 500,000 mIU/Ml.
This is an article from a while back. I have not seen one done lately comparing 11 devices of uHCG .
If the sample has the consistency/ specific gravity of water, a first morning urine should be recommended if all physical symptoms points to pregnancy.
We do not test for specific gravity on all uHCG but most ER patients get their urine dipstick with the uHCG anyway . The physician can make his conclusion and recommendation based on the SG in the urine dipstick.
If not, he may order quantitative serum HCG if pregnancy is suspect.
We do require a specific gravity performed with each pregnancy test order to validate sample acceptability. Samples showing no line present with a less than 1.010 specific gravity are resulted as 'indeterminate' and a blood test is performed.