Mitigating risk of pregnancy and fluoro

[Baron Samedi]

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Curious what others are doing.

While back did a hip injection under fluoro, patient denied any chance of being pregnant and we routinely record date of last menstrual period. Two days after the injection she has a positive pregnancy test. Her mgy was very low and the risk is minimal, but curious what others do to prevent this from happening.

Day of procedure pregnancy test in women of child-bearing age? Avoid fluoro during certain times of cycle? Depend on patient history?

 

[bedrock]

Curious what others are doing.

While back did a hip injection under fluoro, patient denied any chance of being pregnant and we routinely record date of last menstrual period. Two days after the injection she has a positive pregnancy test. Her mgy was very low and the risk is minimal, but curious what others do to prevent this from happening.

Day of procedure pregnancy test in women of child-bearing age? Avoid fluoro during certain times of cycle? Depend on patient history?

pregnancy test in women 15-50 on day of procedure. They must take the test no matter how much they swear they couldn't be pregnant.

 

[RoloTomassi]

Same as bedrock. Have said several congratulations.

 

[lobelsteve]

I would use birth control if undergoing fluoroscopy. But why are you having sex on the fluoro table?
Nevermind, misread the title of the thread.
Or did I?

 

[Agast]

My patient came for her follow up about 8 months later, pushing a stroller. She had tested negative on the day of procedure. Whoops.

 

[painfree23]

I just have them sign a consent asking if they there is a chance they r pregnant

 

[Baron Samedi]

pregnancy test in women 15-50 on day of procedure. They must take the test no matter how much they swear they couldn't be pregnant.

Do you have tests in clinic? Or have them take at home that morning?

 

[bedrock]

Do you have tests in clinic? Or have them take at home that morning?

In clinic

 

[SSdoc33]

testing is overkill IMHO. ask them and document. you dont make women take a text everytime they get an xray or CT scan

 

[plasma.]

This is interesting. In the ER when getting CTs on young females, betaHCG is necessary (as per radiology). I don’t mind because I need the pregnancy test anyways for my work up. Quite often see positives despite patient reassuring me they can’t possibly be pregnant, including a ruptured ectopic. Think I will get the urine preg before flouro procedures. Can bill for collecting urine I think so cost shouldn’t be an issue.

 

[Ducttape]

consider:
getting urine pregnancy test will slow and delay procedural flow. not only does the test need to be run, but the specimen needs to be obtained, and that may take a little time on any patient that has limited oral intake in preparation for the procedure.

there will be a case or two that will test positive and you will not do the procedure, which is great. as a side note, most of what we use for procedures are safe in pregnancy, with the exception of the fluoroscopy.

 

[plasma.]

consider:
getting urine pregnancy test will slow and delay procedural flow. not only does the test need to be run, but the specimen needs to be obtained, and that may take a little time on any patient that has limited oral intake in preparation for the procedure.

there will be a case or two that will test positive and you will not do the procedure, which is great. as a side note, most of what we use for procedures are safe in pregnancy, with the exception of the fluoroscopy.

Agreed, definitely will slow down the day. However, I wonder how females under the age of 50 are usually booked per day in pain clinic, specifically for a fluoro procedure? Can't be too many I'd imagine.

 

[RoloTomassi]

Agreed, definitely will slow down the day. However, I wonder how females under the age of 50 are usually booked per day in pain clinic, specifically for a fluoro procedure? Can't be too many I'd imagine.

Correct, not that many to slow the flow. Schedulers have everyone come 30 min prior to procedure and tell those of age not to pee because there will be a test. It's more a considerate thing to do to make sure, esp on fluoro heavy procedures, rather than to avoid liability. Consent would suffice for that.