SHOULD PREGNANCY TESTING BE ROUTINE IN ADOLESCENT PATIENTS PRIOR TO SURGERY

The reliability of the preoperative history obtained from adolescent p atients in ruling out pregnancy was prospectively evaluated. Four hund red forty-four patients who underwent 525 procedures were questioned p reoperatively regarding the possibility of pregnancy. Regardless of th e history, a urine pregnancy test was ordered in accordance with insti tutional practice. In 508 cases, patients denied the possibility of pr egnancy. Eight patients stated that they might be pregnant, and in six cases the parents responded for the patients and denied the possibili ty of pregnancy. Seventeen patients were not tested due to patient/par ent refusal (n = 9) or inability to void (n = 8). All pregnancy tests were negative except one that was questionably negative. This patient had denied the possibility of pregnancy and had been anesthetized prio r to test results. Follow-up revealed that the patient was not pregnan t. Our data demonstrate that the preoperative history obtained from ad olescent patients at our institution regarding their pregnancy status was in agreement with pregnancy test results. We suggest that a detail ed history regarding last menstrual period, contraception, sexual acti vity, and the possibility of pregnancy be obtained in all postmenarcha l patients presenting for surgery. Although in other populations histo ry and pregnancy testing did not agree 100% of the time, for our adole scent population, human chorionic gonadotrophin (HCG) testing appears to be necessary only if indicated by patient history.