Same-day pregnancy test provides valuable guidance to pre-surgery patients

Jun 16, 2008

The first trimester of any pregnancy is a precarious time, as about 15 percent of women who know they are pregnant will spontaneously miscarry. This risk increases when pregnant women undergo surgery, which is why Hospital for Special Surgery (HSS) in New York instituted a same-day pregnancy testing protocol. A study published in the April issue of Anesthesia and Analgesia shows that this protocol is effective in identifying unknown pregnancies to the benefit of the patient, the physician and the hospital.

"There are no standard recommendations and it is my sense that most places do not have a protocol like this in effect," said Richard L. Kahn, M.D., attending anesthesiologist at Hospital for Special Surgery and lead author of the study. "But the majority of the surgeries HSS performs are elective. By testing all women of child-bearing age on the same day of their surgery we can make sure that the patient has all the facts to make the best informed decision."

The doctors found of 2,588 women tested, five patients had a positive pregnancy test. All of the patients postponed surgery and only one was a false positive.

The American Society of Anesthesiologists gives individual hospitals and physicians the opportunity to define and institute their own policies in regards to pre-operation pregnancy testing. Like many hospitals, Hospital for Special Surgery had been conducting some tests a week before the scheduled surgery, but it wasn't a consistent protocol.

"Pregnancy hormone levels can change within the week leading up to surgery, and HSS was concerned that it was missing some pregnancies," said Dr. Kahn. "We instituted the new policy in November 2004 and the study looked at the cost-benefit ratio within the first full year, January 2005 – January 2006, that the protocol was in effect."

While there is no conclusive evidence, there are associated pregnancy risks with any surgery. Both the stress the mother is under during surgery or the anesthesia could contribute to a spontaneous miscarriage or to an increased chance of birth defects. Doctors at Hospital for Special Surgery always explain the risks to patients who are pregnant, but if the patient herself doesn't know she is pregnant she may not spend much time weighing the risks.

The direct cost associated with each urine pregnancy test is $5.03. Therefore, it cost HSS $3,273 in lab and labor costs to detect each unrecognized pregnancy, though this does not include the indirect costs associated with a cancelled surgery. However, if a woman who didn't know she was pregnant went on to either lose the pregnancy or have a child with a birth defect, the unknown role that anesthesia and surgery may have played in this can be devastating to patient and physician. The benefit of eliminating this possibility, Dr. Kahn said, is more than enough to justify the cost of testing and inconvenience of a postponed surgery.

"Based on the outcome of this study, the same-day pregnancy testing is still in effect at HSS," said Dr. Kahn. "If I were to move to another hospital that did not perform same-day pregnancy testing, I would work to institute a similar policy. What it comes down to is providing the best care for our patients, and I believe this protocol allows us to do that."

Source: Hospital for Special Surgery

Explore further: 'Ice Bucket Challenge' passes $100 mn mark

add to favorites email to friend print save as pdf

Related Stories

China's Alibaba plans IPO for week of September 8

9 hours ago

Chinese e-commerce giant Alibaba plans to hold its initial public offering on the US stock market the week of September 8, the Wall Street Journal reported Saturday, citing a person familiar with the matter.

Tablet sales slow as PCs find footing

9 hours ago

Tablets won't eclipse personal computers as fast as once thought, according to studies by market tracker International Data Corporation (IDC).

Startups offer banking for smartphone users

9 hours ago

The latest banks are small enough to fit in the palm of your hand. Startups, such as Moven and Simple, offer banking that's designed specifically for smartphones, enabling users to track their spending on the go. Some things ...

Recommended for you

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

User comments : 0