# A Clinical Audit of Pregnancy Testing in Females Presenting With Abdominal Pain to the General Surgery Department of a District General Hospital

## TL;DR

This study evaluated how often pregnancy tests were done for women with abdominal pain in a hospital's surgery department and found improvements after awareness initiatives.

## Contribution

The study demonstrates how targeted interventions can significantly improve adherence to clinical guidelines for pregnancy testing.

## Key findings

- Only 41.8% of patients had pregnancy tests in the initial audit.
- After interventions, 80% of patients had pregnancy tests in the follow-up audit.
- The study suggests electronic systems could help ensure compliance with testing guidelines.

## Abstract

Introduction

Guidelines state that all female patients of childbearing age presenting with acute abdominal pain to a surgical department must have a pregnancy test with either urinary or serum beta-human chorionic gonadotropin (𝜷-HCG) testing. This allows complete evaluation of the patient and consideration of a wider range of differential diagnoses, including those that must not be missed, such as a possible ectopic pregnancy. Additionally, management options for conditions unrelated to pregnancy may differ in pregnant women. This audit assessed adherence to guidelines for pregnancy testing in females presenting with abdominal pain to the general surgery department in a district general hospital and the impact of initiatives to improve compliance.

Methods

A retrospective audit to identify pregnancy test completion of all female patients aged between 11 and 55 years presenting to the general surgery department at a district general hospital with acute abdominal pain in August 2022 was conducted. A medical education session, posters, and discussion amongst multidisciplinary team members in a nursing huddle followed to raise awareness. A subsequent prospective audit was conducted in November 2022.

Results

In the initial audit conducted in August 2022, 55 female patients aged between 11 and 55 years presented to the surgical department with abdominal pain. Of these patients, pregnancy testing was only completed for 41.8% (n = 23). Following interventions, a second audit conducted in November 2022 found 30 female patients presenting with abdominal pain. In this cohort, pregnancy testing was completed for 80% of patients (n = 24).

Conclusion

This study highlights the need for regular clinical audits and multidisciplinary discussion in improving and maintaining high standards of patient care and ensuring pregnancy testing of all females of reproductive age presenting with abdominal pain to the general surgery department. Further consideration may be given to the incorporation of recording of pregnancy test status on electronic healthcare systems as part of admission and mandatory checklists.