Emergency Departments Seldom Perform Pregnancy Testing of Adolescents Before Exposure to Radiation

A small number of teen-aged girls undergo pregnancy testing in the hospital emergency department (ED), even when they complain of lower abdominal pain, or before they are exposed to radiation testing.

These findings were presented in October 2012 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans (LA, USA). In the study, researchers reviewed US National Hospital Ambulatory Medical Care Survey data from 2000 to 2009 on female patients aged 14 to 21 who were examined in a hospital ED. Of the 77 million girls who visited an ED over the nine-year period, just 14.5 million (18.7%) were tested for pregnancy. Of the patients complaining of abdominal pain, 42.3% were tested for pregnancy, and of those receiving radiologic imaging, 21.5% were tested. Of patients exposed to radiation that could cause birth defects (such as a chest X-ray or computed tomography [CT] scans), only 27.9% received a pregnancy test. Moreover, disparities in testing were noted based on age, race, and insurance type.

“We were surprised to find that pregnancy testing occurred infrequently,” said study author Monika Goyal, MD, FAAP, from the department of emergency medicine, Children’s Hospital of Philadelphia (PA, USA). “It was particularly concerning that rates of pregnancy testing were low even among females with potential reproductive health complaints or with exposure to radiation through diagnostic testing, like CT scans. These findings underscore the need to develop quality improvement interventions to increase pregnancy testing in adolescent girls in the emergency department, especially among those with higher risk of pregnancy complications.”

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Children’s Hospital of Philadelphia