National multicentre audit of pregnancy status in general surgery admissions in Scotland

Background: Documentation of pregnancy status is an integral component of the assessment of females of reproductive age when admitted to hospital. Our aim was to determine how accurately pregnancy status 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 0800 on 11/05/2015 and 0759 on 25/05/2015. The lower age limit was the minimum age for admission to the adult surgical ward, up to the age of 55 years.
Results: 2743 admissions with 612 (22.3%) females of reproductive age. 82 exclusions leaving a final total of 530; 169 (31.9%) elective and 361 (68.1%) emergency. Documentation of pregnancy status was achieved in 274 (50.7%) cases; 52 (30.8%) elective and 222 (61.5%) emergency. 318 (88.1%) of the emergency admissions had abdominal pain. Of these, 211 (62.9%) had a documented PS. The possibility of pregnancy was established in 227 (43.0%) of cases.
Discussion: Establishing the possibility of pregnancy prior to surgery is poor, particularly in the elective setting. Objective documentation of pregnancy status in the emergency setting in those with abdominal pain is also poor. Our study highlights an important patient 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. Pregnancy status should form part of the pre-theatre safety brief and checklist.