New research presented at this year’s Euroanaesthesia congress (London, Might 27-30) addresses the importance of discussing potential pregnancy and supplying pregnancy testing for women of reproductive age prior to they undergo surgery, to ensure that harm to mother and baby can easily be avoided. The study is by Dr Subhamay Ghosh, Consultant Anaesthetist, Glangwili Total Hospital, Carmarthen, Wales, UK (and formerly of Addenbrookes Hospital, Cambridge, UK, where the research took place) and Dr Gokulnath Rajendran, Department of Anaesthesia Norfolk and Norwich University Hospital, Norwich, UK (and again formerly of Addenbrookes Hospital, Cambridge, UK).
Anaesthesia and surgery throughout unidentified pregnancy could bring about risk to the mother or fetus, or both. Some patients Might require imaging intraoperatively and pregnancy ought to be ruled out prior to surgery. In the USA, the American Society of Anesthesiologists´ Preanesthesia Task Force´ has actually published insight allowing physicians and hospitals to implement their own policies and practices on preoperative (POP) pregnancy testing (PT). Frequency of found POp pregnancy ranges from 0.34% to 2.4%.
In the UK, guidelines NG45 issued in April 2016 by Wonderful (the National Institute for Healthiness and Care Excellence) recommend POpPT ought to be considered complying with informed consent for all of women of reproductive age group (WRAG) and ‘definitely’ on those that point out that they could be pregnant. This latest guideline likewise encourages the progress of locally agreed protocols.
In this study, Ghosh and colleagues aimed to find if all of WRAG had their pregnancy status in the immediate POp period, and the performance of POp urine PT and incidence of unexpected pregnancy.
They analysed data from the Cambridge University theatre database to recognize WRAG (16-55 years) that underwent non-obstetric procedures at Cambridge University Hospital. Electronic clinical notes were reviewed for a period of 8 weeks. A total of 511 patients were identified; 99.6% of WRAG were asked regarding the opportunity of pregnancy. Of these, 1% said they could be pregnant and 3.8% were unsure of opportunity of pregnancy; of these PT was documented negative in 24%. opportunity of pregnancy was denied by 94.7% and of them PT was negative in 17%; 25% were not tested for reasons documented as denial, recent menstruation, sexually inactive or hysterectomy; 57% were not tested and no reasons documented. POpPT were performed much more routinely in the daycare unit (81%) compared to those confessed to main hospital wards (12%).
Although the testing carried out revealed no unknown pregnancies, the reasonable proportions of women tested ? in the 2 those that believed pregnancy was feasible and those that believed it was not ? means that there could be a minimum of some undetected pregnancies in women that go on to undergo a number of surgical procedures.
Dr Ghosh concludes: “Urine pregnancy testing was performed in just 24% of women that were unsure of pregnancy status. There were some inconsistencies in checking and documenting pre-operative pregnancy testing in between wards. By presenting this data to staff and rolling out some guide leaflets we chance to enhance awareness and hence, boost performance. Detecting unknown pregnancy could give an opportunity to discuss and cancel elective surgery or transform perioperative management. This straightforward however considerable test could potentially give a much better and safer service across hospitals globally, to the 2 the mother and the baby.”
###
Disclaimer: AAAS and EurekAlert! are not accountable for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the usage of any sort of guide through the EurekAlert system.
