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Pre-surgery pregnancy status

02 October 2017
Volume 25 · Issue 10


After headlines reported that women had lost babies following surgery, George Winter investigates the ethical and medical conflicts that may arise when women undergo surgical procedures

In 2010, a national newspaper reported that the National Patient Safety Agency database recorded three women who lost their babies following surgery, saying that,

‘In a further 12 cases, the NHS has been sued by women who were not tested prior to their operation … It is thought this is just the tip of the iceberg.’

Yet it appears that this story did not prompt an investigation into how best to establish the pregnancy status of pre-surgical patients, as a recent study from the Scottish Surgical Research Group (SSRG) (Wilson et al, 2017) suggested that the standard assessment of pregnancy status before surgery was not fit for purpose.

Wilson et al (2017) noted that, in the developing world, abdominal pain was the main reason for admission to acute surgical units, and one-third of such admissions were women of reproductive age. In UK guidelines, the National Institute of Health and Care Excellence (NICE) (2003) recommend that pregnancy tests should be conducted before elective surgery only if a woman replies, after questioning, that she may be pregnant; and there are no guidelines on establishing pregnancy status in emergencies. The study's lead author, surgical registrar Dr Michael Wilson, said that this led to an unknowingly pregnant woman being exposed to ionising radiation via a computed tomography (CT) scan, where a diagnosis of pregnancy was made. Dr Wilson said that,

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