Pregnancy testing before an operation, investigation or treatment

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Introduction

National guidance recommends that NHS organisations should establish the pregnancy status of all females between 11 and 55 years before they have certain procedures and treatments. Keeping patients safe in hospital We already ask many questions about a patient’s health; for example the medicines they are taking and if they have any allergies. We will also be asking all females over the
age of 11 questions about possible pregnancy to avoid the risk of harm.

What are the risks of not testing for pregnancy?
 Some operations, investigations and treatments can harm an unborn baby if they are carried out when a patient is pregnant.
 Within the early weeks of pregnancy the body reacts differently to drugs, particularly anaesthetics, so it is very important we know if a patient is pregnant.
 Some drugs may cause harm to the developing baby.
 There is also a chance of miscarriage (losing the baby) if a girl or young woman has an operation or investigation during early pregnancy.

Testing for pregnancy at MKUH
All female patients aged 11 years or older who are having a procedure (e.g. X-ray) or surgery involving a general anaesthetic (putting them to sleep) will be asked to provide a sample of urine for a pregnancy test before their procedure.

Consent
If a doctor considers a young person to be mature enough to make an informed decision, they are judged to be ‘competent to consent’ and they can agree to the pregnancy test for themselves. Competent young people can also refuse to have a pregnancy test. Parents and carers can consent or refuse for their daughter to be tested for pregnancy, if their daughter is not competent to consent for herself. We would want to discuss the reasons with them to help the parents who have parental responsibility, to make the best decisions about treatment and keeping their daughter safe.

Pregnancy test results
The hospital cannot share the result of the pregnancy tests with parents or carers without a competent young person’s permission. We will encourage young people to involve their parent or carer in decisions about their care. For most young people we expect the test will be negative, showing that they are not pregnant, and the procedure can go ahead as planned. We will not routinely inform parents or carers of the result of the pregnancy test, even if it is negative.

For a small number of young people, the test may be positive. We would have to think very carefully about the best way to proceed, and make sure the right care was organised to help with the pregnancy. In some circumstances, a positive result may not be due to pregnancy, and the reasons for this may need to be investigated with an ultrasound scan or blood test.

Sometimes it is necessary to cancel or delay procedures at short notice. If this happens, please do not assume that this is due to the result of a pregnancy test.

Providing the urine sample
• A sample of urine should be collected on the morning of the procedure. The first urine of the day is the best as it is the most concentrated, but it can be collected later.
• If the urine is collected at home the sample should be stored in a suitable container in the fridge until you are ready to travel to Milton Keynes University Hospital.
• Suitable containers can be obtained from your GP, any pharmacy or will be issued on arrival for your operation at MKUHFT.

For further information
If you have any questions about: pregnancy testing, consent, competency and/or sharing test results, please visit the Milton Keynes University Hospital website: http://www.mkuh.nhs.uk/

The RCPH Guidelines and additional materials: https://www.rcpch.ac.uk/pregnancychecks

NSPCC Gillick competency and Fraser guidelines: https://www.nspcc.org.uk/preventing-abuse/childprotection-system/legal-definition-child-rights-law/gillickcompetency-fraser-guidelines/