Service evaluation of qLabs FIB point-of-care fibrinogen testing in acute obstetric haemorrhage in a UK maternity unit

Abstract

Introduction: Point-of-care testing (POCT) is recommended to guide the correction of coagulopathy in post partum haemorrhage (PPH). Funding for thromboelastography was unavailable, but we had access to the MHRA approved qLabs FIB measurement system. This is a small, portable device with relatively low-cost consumables. Given the paucity of data on the use of qLabs FIB fibrinogen measurement in the clinical setting, we sought to evaluate its reliability in the context of acute PPH. Method(s): In 36 patients with acute PPH, paired coagulation samples from a single venepuncture, were obtained. qLabs FIB point-of-care fibrinogen measurements were compared with laboratory Clauss fibrinogen results (Fig. 1; Bland-Altman plot). Fifteen cases were excluded from the plot due to fibrinogen values exceeding the device's measurement range (>4 g/L) or haemolysed laboratory samples. The study was classified as a service evaluation by the hospital Research Ethics Committee, and individual patient consent was not required. Result(s): Paired measurements from 24 samples from 21 patients were compared. The mean difference (bias) between the two methods was -0.0788 and was not statistically significant (95% CI: -0.2576 to 0.1001; p = 0.3719, SD-0.4236). Among the 13 observations with qLabs FIB values >4 g/l, corresponding laboratory measurements were greater than 3.8 g/l in all cases except one, which had a value of 3.11 g/l. [Formula presented] Conclusion(s): Hypofibrinogenaemia is typically the earliest marker of acute obstetric coagulopathy. In our clinical experience, the qLabs FIB system has proven reliable for the detection and exclusion of hypofibrinogenaemia in PPH. The system is portable and provides a fibrinogen result within 1-10 min, making it suitable for use in acute clinical settings. Acknowledgement: We thank Stago UK Ltd for loaning us the qLabs FIB meter and supplying test strips during the clinical evaluation phase. [Formula presented] Copyright © 2026