April 23, 2011

Should all Reproductive age women require Pre Op UPT

This is my past year professional III exam question. The statement is,

"Urine for pregnancy test is a necessary investigation in all female patients in the reproductive age group"

The answer is false because

1) The American Society of Anesthesiologist (ASA) committee on Ethic stated that patient should be offered but not required to undergo pregnancy test unless there is compelling medical reason to know that patient is pregnant

2) Pregnancy test should be offered to female patients of childbearing age and for whom the result would alter patient's management

3) Detailed history should be obtained in all reproductive age group female patient and urine pregnancy test should be done if indicated from the history

4) A task force by ASA in 2002 entitled "Practice Advisory for Preanesthesia Evaluation" agree that preoperative test should not be ordered routinely. Preoperative should be done or required on a selective basis for purpose of guiding and optimizing perioperativemanagement. Indication for testing should be documented and based on medical and physical examination. Since the history could be unrelieble, the recommend that the urinary pregnancy test should be offered to all woman in reproductive age group rather than require to undergo the testing.


Lee A. Fleisher, " Evidence-Based Practice of Anesthesiology, 2nd Edition", Saunders Elsevier, 2009


  1. Salam Bro,
    I applied for a summmer surgical attachment at USM. I was wondering if you could give me some pointers on what to expect. Your help will be greatly appreciated.
    Thanks :)

  2. wsalam wbt.

    sorry couldn't get your point.mind to explain more? you means expecting what kind of experience you would gather or expecting what?

  3. Salam,
    Apology for being vague. What I meant was, since its a neuro and orthopedic surgical attachment, what could I do in advance in terms of preparations, apart from the obvious of course. Its my first time so I don't want to disappoint anyone. Plus if there are any reference material you could point me to, then that would be really great. Thanks in advance :)

  4. Wsalam wbt..

    As far as i'm concern, so far not so many students doing elective in neurosurgery. even for us, neurosurgery is considered as a minor posting with duration of 2 weeks only. however, USM did have a lot of neuro cases and it's pretty awesome.

    For OT, usually the surgeon will allow you to scrub in emergency cases only. some may allow you to scrub in elective cases like brain tumor surgery.. however, depending on the surgeon, some of them may dont want to be disturbed if it is a difficult operation. even so, you still can observe the OT quietly.

    apart from that, you may attach yourself with MO to follow their rounds in wards or seeing patient at outpatient clinic.

    since neuro is a minor posting for us, we dont have many textbook and rather use a simple textbook which is illustrated textbook for neurology and neurosurgery..

    for orthopedic, we have few teams like Oncology and Reconstructive surgery (OORU), spine, hand, trauma, arthroplasty and paed.. you may attach to these team as what have you been discussed with the elective coordinator or orthopedic head of department.

    for ortho, we have a lot of interesting cases esp in OORU and Hand team... you may follow the morning round, outpatient clinic or OT...

    textbook in orthopedic, we mostly use three books, Appley, Essential orthopedic and trauma, and pocketbook of orthopaedics and fractures......

    hope that helps you.. all the best in your elective

    with regards.


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