To the Editor:--We found the paper by Manley et al. to be timely and informative. We are trying to develop a rational policy toward preoperative testing, especially as it pertains to pregnancy testing in females of childbearing age. As was pointed out by the authors, history often is not enlightening in ruling out the likelihood of early gestations in women with otherwise normal reproductive capacity (irregular cycles, language barriers, fear of others knowing of sexual activity); therefore, urine or serum pregnancy testing is done preoperatively. In the authors' routine, pregnancy testing was performed within 6 days of the scheduled surgery if possible; otherwise, it was performed the day of surgery. In all, 7 of 2,056 patients (0.3%) were found to be pregnant, resulting in the cancellation of all 7 planned procedures. We are curious how many of these seven patients who tested positive for pregnancy were discovered by testing performed on the day of surgery. If a majority of them were diagnosed by testing on the day of surgery, should we reconsider ever testing these patients for pregnancy before the day of the scheduled procedure, or test them immediately on arrival for their procedure or with home testing kits the night before?
Norman J. Zeig, M.D., Chair.
Zvi Herschman, M.D., Director of Critical Care, Department of Anesthesiology, Saint Barnabas Medical Center, Old Short Hills Road, Livingston, New Jersey 07039.