Pregnancy testing before an operation, investigation or treatment

Information for parents and carers

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Pregnancy testing before an operation, investigation or treatment – PIAG 002 (157kB)

Introduction

National guidance recommends that NHS organisations should establish the pregnancy status of women and girls aged between 12 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 girls and young women questions about 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 Alder Hey

All female patients aged 12 years or older who are having a procedure 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 1considers a young person to be mature enough, they are judged to be ‘competent to consent’ and can agree to the pregnancy test for themselves. Competent young people can refuse to have a pregnancy test.

Parents and carers can refuse their daughter being tested for pregnancy if their daughter is not competent2 to consent. We would want to discuss the reasons with them to help us make the best decisions about treatment and keeping their daughter safe.
Some procedures may need to be cancelled, or re-scheduled, if a pregnancy test is not completed. Ultimately the decision to continue with the procedure is that of the clinical team.

Pregnancy Test results

The hospital cannot share the result of 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 Alder Hey Hospital.
• Suitable containers can be obtained from your GP, any pharmacy or Alder Hey. Please ring 0151 252 5488 (or via switchboard on 0151 228 4811, extension 2488) if you would like a container sent to you by post.

References

1. The RCPCH Guidelines and additional materials: http://www.rcpch.ac.uk/pregnancychecks.
2. NSPCC Gillick competency and Fraser guidelines https://www.nspcc.org.uk/preventing-abuse/child-protection-system/legal-definition-child-rights-law/gillick-competency-fraser-guidelines/

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 002