Ethics of pregnancy testing in patients undergoing anaesthesia and surgery

Abstract

A patient's pregnancy status should be determined prior to undergoing any procedure which has the potential to cause harm to a pregnant mother or fetus. Anaesthesia and surgery, alongside the associated physiological stress and radiation exposure, pose some increased risks to the pregnancy and developing fetus. The fetus is most vulnerable in the first trimester, when the mother is more likely to be unaware of the pregnancy. National guidance suggests all women of child-bearing potential should be offered a pregnancy test prior to surgery if pregnancy status is uncertain. The results of this test can be used to inform decision-making regarding anaesthetic and surgical techniques, and in relation to timing of surgery. Whilst the testing is done in part to protect the unborn child, the fetus in of itself has no legal personality or rights until birth, and ultimately the decision to consent to surgery is that of the patient. Elective procedures can be postponed to minimize the risk to the pregnancy of miscarriage or teratogenicity. Most patients will be able to consent to pregnancy testing and the procedure. Potential ethical issues arise if the patient lacks capacity or is under the age of 16.