Document Detail


Patient self assessment of pregnancy status in the emergency department.
MedLine Citation:
PMID:  16794101     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Division of Emergency Medicine, University of Washington Medical Center, Seattle, WA 98122, USA. strote@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cohort Studies
Emergency Nursing / methods*
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Pregnancy
Pregnancy Tests / methods*
Prospective Studies
Questionnaires*
Comments/Corrections

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


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