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National multicentre audit of pregnancy status in general surgery admissions in Scotland
  1. Michael S J Wilson1,
  2. Matilda Powell-Bowns2,
  3. Andrew G Robertson2,
  4. Andreas Luhmann1,
  5. Colin H Richards3
  6. on behalf of the Scottish Surgical Research Group
    1. 1Department of General Surgery, NHS Tayside, Ninewells Hospital, Dundee, UK
    2. 2Department of Trauma and Orthopaedics, NHS Lothian, Edinburgh, UK
    3. 3Department of General Surgery, NHS Grampian, Aberdeen, UK
    1. Correspondence to Dr Michael S J Wilson, Department of General Surgery, Ninewells Hospital, Dundee DD1 9SY, UK; michaelwilson3{at}nhs.net

    Abstract

    Background Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery.

    Methods A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years.

    Results There were 2743 admissions, with 612 (22.3%) women of reproductive age. After 82 exclusions, the final total was 530: 169 (31.9%) elective and 361 (68.1%) emergency. Documentation of PS was achieved in 274 (51.7%) cases: 52 (30.8%) elective and 222 (61.5%) emergency. In 318 (88.1%) of the emergency admissions, the patient had abdominal pain. Of these, 211 (65.1%) had a documented PS. The possibility of pregnancy was established in 237 (44.7%) cases.

    Discussion Establishing the possibility of pregnancy before surgery is poor, particularly in the elective setting. Objective documentation of PS in the emergency setting in those with abdominal pain is also poor. Our study highlights an important safety issue in the management of female patients. We advocate electronic storage of pregnancy test results and new guidelines to cover both elective and emergency surgery. PS should form part of the pre-theatre safety brief and checklist.

    • patient safety
    • pregnancy test
    • general surgery

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    Footnotes

    • Twitter Follow Michael Wilson @WilsonMSJ

    • Collaborators The Scottish Surgical Research Group. The following should be credited as collaborative authors: Rhona Hurley, Ahmed El-Medany, Claire-Louise Inwood, Saskia Mason, Angela S Gillan, Susan Williams, Rachel Thomas, Bryan Maybin, Carol Barry, Fiona Rutherford, Graham Prentice, Alastair C McKay, Joseph E Crozier, Rosalyn D Shearer, Jenny Sinclair, Eleanor Brooke, Maria Coats, Terence Chong, Diana E Yung, Naomi Heller, Carly Bisset, Laura Arthur, Robert Anderson, Katrina Knight, Christopher Kay, Michael Gillespie, Caroline J Davidson, Adam Couves, Carina McGuire, Peter Alexander, Imran Z Inam, Jay Maloney, Nick Simpson, Nina Gill, Sivarajah Sharmini, Ewan Semple, Esther Wilson, Anne S Ewing, Frances Kent, Adam Young, Naomi Dodds, Alice Baggaley, Bilial Ibrahim, Ibrahim Ibrahim.

    • Contributors All authors contributed to the design of study and were involved in various stages of preparation of the submitted manuscript. Collaborators were involved in data collection.

    • Competing interests None declared.

    • Ethics approval National Caldicott Guardian.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The Scottish Surgical Research Group is in possession of the centralised database used to produce this article. This includes data relating to length of stay, age of patient, radiological investigations and operative interventions over and above the data described here.

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