Detection of unknown early pregnancy. A matter of safety

Abstract

Almost 2% of females admitted as accident victims to a general hospital-teaching facility were pregnant without their physicians knowing it. Emergency treatment of such patients may overshadow other aspects of holistic care and have adverse consequences when a pregnancy is unrecognized. These cases illustrate the importance of always performing a complete physical examination and obtaining a good history that includes menstrual data. When appropriate, we recommend routine use of the serum human chorionic gonadotropin test for pregnancy. It is a simple and reliable means of detecting pregnancy by ten days after nidation, and its use protects the patient, physician, and unborn child. Safer health service is the result.

PIP: Female patients are sometimes medically treated, especially under emergency conditions, without knowing whether they are pregnant. As a result, medical procedures such as radiologic examinations and teratogenic substances are sometimes administered to them with adverse consequences. An easy and reliable means of detecting early unknown pregnancy is therefore important. A serum HCG test was performed on all women of childbearing age except obstetric and psychiatric patients admitted to Humana Hospital University of Louisville over a 10-day period in 1986. No physicians in the hospital were aware of the testing except the researchers and the clinical laboratory director. Of 110 patients tested, 2 had elevated test values and turned out to be pregnant; neither pregnancy had been detected on admission. The 1st woman had been admitted to hospital for treatment of smoke inhalation and a 2nd-degree burn. Before HCG test results were received, several chest x-rays were administered to her. The 2nd woman was admitted for treatment of a head injury and lacerations received in an automobile accident. She likewise received several x-ray examinations before HCG testing revealed her pregnancy. HCG testing has proven to be a simple and reliable means of detecting pregnancy as early as 10 days after nidation. Such testing can be very useful, particularly in emergency situations, when non-traumatic health conditions can easily be overlooked.