Routine pregnancy testing in adolescents: to test or not to test—what is the answer?

Policies pertaining to routine pre-operative pregnancy testing in adolescent females continue to challenge pediatric anesthesiologists. The expectation of safety for the mother regardless of pregnancy status, no risk of teratogenicity of a single, general anesthetic, and a remaining suspicion that inhalation anesthetics are abortofacients guides this debate. Many medical, legal, ethical, moral, religious, economic justice, and practical issues are involved when considering routine pregnancy testing which must: 1) inform the parents of the test occurring and decide the consent procedures; 2) decide what to do with positive results; 3) decide who will receive the information of the positive test results; and 4) assure proper patient support and care from ancillary services, eg, counseling, child-life, social work, etc., in the event of a positive test. We should inform our patients of the controversy and make them aware of the potential, albeit slight, risk of fetal loss or harm, while offering pregnancy testing for those concerned.