Checking pregnancy status in adolescent girls before procedures under general anaesthesia

J F Donaldson; S J Napier; M Ward-Jones; R A Wheeler; P M Spargo

doi:10.1136/archdischild-2011-301229

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Arch Dis Child

doi:10.1136/archdischild-2011-301229

Short research report

Checking pregnancy status in adolescent girls before procedures under general anaesthesia

¹Senior House Officer, Wessex Regional Centre for Paediatric Surgery, Southampton, Hampshire, UK
²Specialist Registrar, Anaesthetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
³Honorary Senior Lecturer in Clinical Law, Southampton University, Southampton, UK
⁴Consultant Paediatric Surgeon, Wessex Regional Centre for Paediatric Surgery, Southampton, Hampshire, UK
⁵Consultant Paediatric Anaesthetist, Anaesthetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK

Correspondence to Dr S J Napier, Anaesthetics Department, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire SO16 6YD, UK; sarahjnapier{at}yahoo.co.uk

Contributors SJN, MWJ and PMS conducted the small study. PMS conducted the national survey. JFD, SJN and PMS conducted the local survey. RAW provided legal and ethical guidance including aspects of study design and analysis. All authors made a significant contribution to drafting and/or revising the article and have approved the final version for submission. JFD is guarantor of the paper.

Received 20 October 2011
Accepted 19 January 2012
Published Online First 23 March 2012

Abstract

Objective Surgery, ionising radiation and anaesthesia in the presence of an undetected pregnancy could be harmful. British guidelines state that female patients of 'childbearing age' should have their pregnancy status established before surgery. Approaching this topic with an adolescent girl can be challenging.

Design The authors conducted an observational study and a survey in their institution and a national survey of Association of Paediatric Anaesthetists (APA) linkmen.

Setting Local: Southampton. National: UK.

Results Both surveys demonstrate widespread concerns about inconsistent and informal practices. Only 45% of respondents in the authors' institution stated they ask adolescent girls if they could be pregnant. 40% of APA linkmen were unaware of national guidelines.

Conclusions This work illustrates the need for consistent national guidance. We propose that all girls who have reached menarche should be routinely offered a urine pregnancy test before any procedure under general anaesthesia.

Footnotes

Competing interests RAW has provided advice concerning forthcoming national guidance on this topic. There are no other competing interests to declare.
Provenance and peer review Not commissioned; externally peer reviewed.