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Pregnancy testing for adolescents lacking in EDs


Few adolescent females undergo pregnancy testing in the ED, even when they complain of lower abdominal pain or before they are exposed to radiation for tests or examinations, according to a study.

Researchers reviewed National Hospital Ambulatory Medical Care Survey data from 2000 to 2009 on female patients ages 14 to 21 who were examined in an 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 reporting 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 radiograph or CT scan), only 27.9% received a pregnancy test. Disparities in testing were noted based on age, race and insurance type.

“We were surprised to find that pregnancy testing occurred infrequently,” Monika Goyal, MD, FAAP, an author of the study, said in a news release. “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 ED, especially among those with higher risk of pregnancy complications,” added Goyal, of the University of Pennsylvania School of Medicine and Children’s Hospital Philadelphia.

The study was presented this month at the American Academy of Pediatrics’ national conference and exhibition in New Orleans.


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