Comparison of pregnancy exclusion criteria between women in their earlier and later reproductive years using the Pregnancy Reasonably Excluded Guide (PREG) prior to intrauterine procedures.
Petra Casey (US), Margaret Long (US)
[Casey] Mayo Clinic, [Long] Mayo Clinic
Context:In a procedure-based practice, a predictive yet cost efficient way of excluding pregnancy is needed. Objective: To compare criteria for pregnancy exclusion in women in their earlier vs. later reproductive years using a history based tool. Patients: Women ages 18-55 years presenting for intrauterine procedures. Methods: The PREG, partly based on WHO criteria, was administered at Mayo Clinic. Responses included: currently pregnant, negative pregnancy test today, started normal menses within 7 days, no coitus since early pregnancy loss, delivery within 4 weeks, no coitus since last menses, consistent use of hormonal contraception, tubal ligation, partner with vasectomy, menopause, no coitus since delivery or none of the above. Interventions:Chi-square analysis was used for comparison between responses in younger (age 18-35) vs. older (age 45-55) women. Main outcome measures:Differences in rate of pregnancy testing and of PREG responses between the age groups. Results: Only 13.3% of 98 older and 19.4% of 232 younger women required pregnancy testing following PREG. In older women, the most common pregnancy exclusion criteria were: bilateral tubal ligation (20.4%), vasectomy (14.3%) and no coitus since last menses (13.3%). In younger women the most common pregnancy exclusion criteria were: no coitus since delivery (21.5%), PREG-triggered pregnancy test (19.4%) and hormonal contraception (16.8%). Pregnancy was more commonly excluded in the older age group based on BTL (p=0.002), vasectomy (p<0.001), and menopause (p<0.001) whereas in the younger group, pregnancy was more likely excluded based on no coitus since delivery (p<0.001) and PREG-triggered pregnancy test (p=0.004). Conclusions: Later reproductive age women are more likely to have pregnancy exclusion based on history than younger women. The most common criteria for pregnancy exclusion differ with age.