Document Detail

Patient self assessment of pregnancy status in the emergency department.
MedLine Citation:
PMID:  16794101     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Pregnancy tests are often performed routinely for female emergency department (ED) patients of reproductive age. One major reason is a perception that patients are unreliable in predicting their own pregnancy status. We hypothesised that patients could reliably predict that they were not pregnant.
METHODS: The study used a prospective cohort design, in an urban academic ED, from January 19 to May 19, 2004. All patients for whom a pregnancy test was ordered were asked about their sexual history as well as two additional questions: "Do you think you might be pregnant?" and "Is there any chance you could be pregnant?" Patients with already documented pregnancies were excluded.
RESULTS: A total of 474 patients had pregnancy tests performed that met inclusion criteria. Eleven (2.3%) tests were positive. Among patients who answered no to both questions (337), one test (0.3%) was positive (negative predictive value (NPV) 99.7%, likelihood ratio (LR) 0.13 (95% CI, 0.02 to 0.82)). The other historical factor with a high NPV (100%) was not being sexually active (LR not calculable). All pregnancies occurred in patients with gastrointestinal or genitourinary as the chief complaint: this comprised only 56% of the presentations for which tests were ordered.
CONCLUSION: Sexual history and self assessment can be used as a highly effective predictor of a patient not being pregnant. Given the risks of missed pregnancy in the ED, and low monetary and time cost of pregnancy tests, frequent testing is still recommended in most instances.
J Strote; G Chen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  23     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-23     Completed Date:  2006-12-14     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  554-7     Citation Subset:  IM    
Division of Emergency Medicine, University of Washington Medical Center, Seattle, WA 98122, USA.
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MeSH Terms
Cohort Studies
Emergency Nursing / methods*
Middle Aged
Predictive Value of Tests
Pregnancy Tests / methods*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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