IADR Abstract Archives
20 Year Study of Undiagnosed Pregnancy in Oral Surgery Patients
Objectives: Ambulatory parenteral anesthesia is an important component of pain and anxiety management for the oral & maxillofacial surgeon. Our ambulatory clinic is in a large urban teaching hospital complex. Because it has been well established that anesthetic agents can be harmful to the embryo or fetus, our hospital routinely tests women of child bearing potential for pregnancy prior to administration of anesthesia. Our department initiated a similar testing protocol in the ambulatory clinic 20 years ago.
We initiated a prospective observational study of urine pregnancy testing data to periodically determine the percent of women who correctly knew their preoperative pregnancy status when presenting to our clinic for oral surgery under IV anesthesia.
Methods: Data on preoperative urine sampling for pregnancy was collected regularly for 20 years. The total number of women tested was compared with the number who tested positive, but had denied being pregnant.
Results: Analysis of initial data after 26 months of this study demonstrated that of 252 women, eight (3.2%) tested positive. After these data were analyzed, the nurse was instructed to ask the more targeted question “as far as you know, this morning are you pregnant?” to determine if this specific question improved the correct responses. After another 26 months, analysis revealed 281 women tested, with five (1.8%) testing positive, a 44% improvement. Using this latter specific questioning, testing of 2,376 patients in 20 years demonstrated 38 (1.6%) tested positive. Subtracting the initial cohort of 252 patients with eight positive receiving less precise questioning, 30 of 2,124 (1.4%) patients did not know they were pregnant.
Conclusions: This study suggests that despite careful preoperative questioning, 1.4% women may not know they are pregnant. Practitioners should consider this when delivering IV anesthesia to women of child bearing potential. The consequences of possibly compromising the health of the fetus should be considered.
We initiated a prospective observational study of urine pregnancy testing data to periodically determine the percent of women who correctly knew their preoperative pregnancy status when presenting to our clinic for oral surgery under IV anesthesia.
Methods: Data on preoperative urine sampling for pregnancy was collected regularly for 20 years. The total number of women tested was compared with the number who tested positive, but had denied being pregnant.
Results: Analysis of initial data after 26 months of this study demonstrated that of 252 women, eight (3.2%) tested positive. After these data were analyzed, the nurse was instructed to ask the more targeted question “as far as you know, this morning are you pregnant?” to determine if this specific question improved the correct responses. After another 26 months, analysis revealed 281 women tested, with five (1.8%) testing positive, a 44% improvement. Using this latter specific questioning, testing of 2,376 patients in 20 years demonstrated 38 (1.6%) tested positive. Subtracting the initial cohort of 252 patients with eight positive receiving less precise questioning, 30 of 2,124 (1.4%) patients did not know they were pregnant.
Conclusions: This study suggests that despite careful preoperative questioning, 1.4% women may not know they are pregnant. Practitioners should consider this when delivering IV anesthesia to women of child bearing potential. The consequences of possibly compromising the health of the fetus should be considered.