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Investigators used a national survey of hospital emergency departments (EDs) to determine frequency and patterns of pregnancy testing in adolescents from 2005 to 2009. Of 11,431 visits identified (representing 41 million U.S. ED visits for females ages 14 to 21 years), 21% had pregnancy testing. Pregnancy testing was performed in only 45% of adolescents with potential reproductive health complaints (lower abdominal, pelvic, or genital pain; vaginal discharge or bleeding; or dysuria), and in only 37% of adolescents exposed to teratogenic radiation from computed tomography. Among visits for potential reproductive health complaints, pregnancy testing was less likely in Hispanic than non-Hispanic black/African American patients (adjusted odds ratio, 0.71), in admitted than discharged patients (AOR, 0.35), and in the Northeast than the Midwest (AOR 0.56).
Goyal M et al. Frequency of pregnancy testing among adolescent emergency department visits. Acad Emerg Med 2013 Aug; 20:816. (http://dx.doi.org/10.1111/acem.12186)
Comment
As the authors point out, there are almost one million U.S. teen pregnancies annually, and more than 80% are unintended. All post-pubertal female adolescents presenting to the emergency department with symptoms that could be either explained or affected by pregnancy should be tested.