Pre-Surgery Test Reduces Risk to Miscarry

The doctors of Hospital for Special Surgery (HSS) found of 2,588 women tested, five patients had a positive pregnancy test. All of the patients postponed surgery. 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, HSS 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 Richard L. Kahn, Medical Doctor, attending anesthesiologist at HSS. “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. Even if doctors explain the risks in case of pregnancy to the patient, she may not spend much time weighing the risks if the patient herself doesn’t know she is pregnant.

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.; Source: Hospital for Special Surgery