Pregnancy Screening Test Research Articles

Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review

(Anesth Analg. 2024;138(5):980–991. doi: 10.1213/ANE.0000000000006669) Informed consent has been required in the United States since 1914, though it has been presented with occasional challenging situations in the context of certain procedures or conditions. One of these occasions is increasing concerns surrounding maternal-fetal conflicts and the rights of pregnant patients to undergo elective anesthesia and surgery. This article is a narrative review that examines the ethical principles of pregnancy testing in preanesthesia patients.

The effect of music on pain, anxiety and satisfaction during nonstress testing.

To determine the effect of instrumental music played during Nonstress Test (NST) on pain, anxiety and satisfaction. This research was planned as randomised controlled. The sample of the study consists of 64 pregnant women. In data collection, a survey form containing socio-demographic characteristics, State-Trait Anxiety Scale, Visual Analog Scale (VAS) and Evgeny Grinko-Valse piece were used as music. Among the groups where music was applied, satisfaction with the procedure was significantly high (X2: 12.666, p: 0.049). No significant difference was detected between anxiety and pain conditions (p > 0.05). The scale scores of the groups before and after the procedure were evaluated; Before the procedure, significant differences were detected between the groups in terms of trait anxiety and fear of pain. As a result of the evaluation made after the procedure, there are significant differences between state anxiety and fear of pain (p < 0.05). It was determined that music played during the NST procedure reduced state and trait anxiety. Satisfaction levels are also higher among the group that is listened to music. A successful pregnancy is important for the health of mother and baby. Reducing anxiety and stress, especially during the examinations, ensures that the process continues successfully. It is recommended that music played during pregnancy examinations and screening tests be used in clinics and during the procedure to increase satisfaction and reduce anxiety.

Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review

(Anesth Analg. October 6, 2023. doi: 10.1213/ANE.0000000000006669. Online ahead of print) The process of informed consent upholds the principle of patient autonomy, rooted in US constitutional principles of privacy and noninterference. It has been legally required in the United States since 1914, ensuring that individuals have the right to determine what happens to their bodies, as Schloendorff v. New York Society Hospital ruled. The recent US Supreme Court decision on abortion has raised concerns about maternal-fetal conflicts and the rights of pregnant patients to undergo elective anesthesia and surgery. Ethical and legal requirements for informed consent in medical testing vary, with challenges in addressing routine laboratory testing. Not all medical tests carry the same ethical implications, but they should all consider beneficence, nonmaleficence, and patient autonomy. Focusing on the need for preanesthesia pregnancy testing remains a concern in anesthesia and surgery practices. The primary premise is preventing harm to the fetus, but this must be supported by medical evidence and adhere to ethical standards. No study conclusively demonstrates that anesthetic agents significantly increase rates of early human fetal loss or malformations. There is no evidence that anesthetic drugs are generally teratogenic or pose a significant risk of harm to the fetus. While such risks are small, they cannot be guaranteed to be absent.

Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review.

Respect for patient autonomy is a pillar of medical ethics, manifested predominantly through informed consent. Mandatory (routine) nonconsented preoperative urine pregnancy testing does not adequately respect patient autonomy, is potentially coercive, and has the potential to cause harm medically, psychologically, socially, and financially. Inaccuracies in pregnancy testing can result in false-positive and false-negative results, especially in early pregnancy. There is substantial scientific evidence that anesthesia is not harmful to the fetus, raising the question of whether pregnancy testing provides substantial benefit to the patient. Not performing a preanesthesia pregnancy test has not been associated with significant medicolegal consequences. We review the ethical implications of mandatory preanesthesia pregnancy testing in light of these facts.

The role of maternal serum alpha-fetoprotein in preterm birth: A literature review

Preterm birth is one of the most important global issues. Mortality and morbidity among children under 5 years, including neonates, is affected by preterm birth. A good maternal care, health workers, and health facilities play an important role in the outcome of pregnancy, including preterm birth. An early screening test for pregnancy is crucial to find any abnormality thus preterm birth can be predicted and the following treatment may be applied without delay. One of potential biomarker for the screening test is alpha-fetoprotein (AFP) that can be found in maternal serum. Web-based literature search was carried out using several keywords. This literature review aims to collect data and articles to conclude the correlation of the potential biomarkers in diagnostic of preterm birth.

Clinical application of noninvasive prenatal testing in twin pregnancies: a single-centre experience

Objectives To evaluate the clinical efficiency of non-invasive prenatal testing (NIPT) for fetal chromosomal aneuploidy screening in twin pregnancies. Methods A total of 1650 women with twin pregnancies were enrolled in the study, which underwent NIPT at the Southwest Hospital, Army Medical University, Chongqing, China from January 2013 to June 2022. Fetal karyotyping analysis was conducted in high-risk patients, with subsequent follow-up on pregnancy outcomes. Results In 1650 pregnancies, NIPT results showed ten cases of the fetal chromosome aneuploidy, of which six cases were true positive and four cases were false positive. The sensitivity, specificity, positive predictive value (PPV), and false-positive rate (FPR) of trisomy 21 were 100%, 99.79%, 57.14%, and 0.18%, respectively. Sensitivity, specificity, PPV, and FPR of trisomy 18 were 100%, 99.94%, 50%, and 0.06%, respectively. The sensitivity, specificity, PPV, and FPR of trisomy 13 were 100%, 100%, 100%, and 0%, respectively. No false negatives were detected and the negative predictive value (NPV) was 100% of the total. Eleven pregnancies failed the NIPT test with no-call due to the low fetal fraction (< 4%). Conclusions NIPT is a high-performing routine primary prenatal screening test in twin pregnancies, with high sensitivity and specificity in screening for fetal aneuploidy.

False-positive urine pregnancy screening tests are uncommon in the hospital setting among patients with bowel-containing urinary tract reconstruction

False-positive urine pregnancy screening tests (UPST) have been reported among patients with bowel-containing urinary reconstruction (BCUR). However, the true frequency of such inaccurate results, which have been attributed to urinary mucous or other proteins interfering with or mimicking the binding of beta-HCG in the assay, is unknown in this population. We sought to determine the incidence of false-positive pregnancy screening tests among this patient population at our institution. Using existing databases of patients with spina bifida, bladder exstrophy, and genitourinary rhabdomyosarcoma, we identified female patients with BCUR who had UPST over a 10-year period as screening prior to procedures or imaging. Patient and test result information was recorded. A total of 120 patients with a history of BCUR were identified: 33 with spina bifida, 73 within the exstrophy-epispadias complex (EEC), and 14 with genitourinary rhabdomyosarcoma. Of this group, 46 patients (38%) had at least one UPST during the study period; 15 had 1 UPST, 6 had 2 UPSTs, 4 had 3 UPSTs, and 21 had greater than 3 UPSTs, for a total of 244 UPST in this cohort. UPSTs used at our institution included Sure-Vue brand and Alere brand (HCG sensitivity 20mIU/ml). Types of BCUR included ileal enterocystoplasty in 25 patients, colon enterocystoplasty in 6, stomach enterocystoplasty in 5, composite enterocystoplasty in 7, and continent catheterizable channel alone (e.g. Yang-Monti, appendicovesicostomy) in 3 patients. Of the 244 UPSTs in patients with BCUR, zero (0%) were positive. Despite reports in the literature that false-positive UPST are common among patients with bowel-containing urinary diversions, we found no positive UPST among patients with BCUR in the healthcare setting. False-positive UPST in the home setting may be due to variability in sensitivity thresholds, binding agents, technical errors in test technique, kit quality control, or other factors.

Does the Use of Low Molecular Weight Heparin Affect Pregnancy Screening Test Results?

Does the Use of Low Molecular Weight Heparin Affect Pregnancy Screening Test Results?

Comparing pregnancy, childbirth, and neonatal outcomes in women with idiopathic polyhydramnios: a prospective cohort study

BackgroundIn this prospective cohort study, the perinatal outcome in idiopathic polyhydramnios compared with normal pregnancies was examined.MethodsThis was a prospective cohort study of 180 singleton pregnancies who received care at the referral gynecology clinic of Yasuj, Iran between 2018–2020. The inclusion criteria comprised singleton pregnancies, gestational age > 34 weeks; fetuses without structural and chromosomal abnormalities in pregnancy screening test, no maternal diabetes, negative TORCH negative screening test, no Rh factor isoimmunization. Polyhydramnios was defined as: (i) amniotic fluid index ≥ 24 cm; (ii) maximal vertical pocket of ≥ 8 cm. Perinatal outcomes were recorded in both groups.ResultsPostpartum hemorrhage (7.8% vs. 2.2; OR: 1.60; 95% CI 1.09–2.34) and cesarean delivery (51.11% vs. 21.11; OR: 1.88; 95% CI 1.42–2.50) and respiratory distress (4.4 v vs. 0; OR: 2.04; 95 C CI 1.75–2.80) was significantly higher in the idiopathic polyhydramnios (P ≤ 0.05) compared to normal pregnancy, which increased with severity of idiopathic polyhydramnios.ConclusionIn conclusion, the results of the current study, suggest that idiopathic polyhydramnios may be associated with a higher rate of postpartum hemorrhage, cesarean delivery, and respiratory distress than a normal pregnancy.

Performance of noninvasive prenatal screening in twin pregnancies: a retrospective study of 5469 twin pregnancies

Objectives To evaluate the performance of noninvasive prenatal screening (NIPS) for the fetal common aneuploidy screening in twin pregnancies. Methods The data of 5469 women with twin pregnancies were collected in this retrospective observational study between January 2017 and December 2018. Patients underwent NIPS as first-line screening or after standard serum screening for fetal aneuploidy. The performance of NIPS was examined, and a regression analysis was performed to investigate testing failure in cases of low fetal fraction. Results In this study, 2231 (40.8%) patients opted for NIPS as the primary prenatal screening test, and 3238 (59.2%) opted for serum screening, including 440 patients who opted for NIPS after serum screening. Among the 2671 pregnancies with available NIPS outcomes, 11 cases of aneuploidy were identified, seven of trisomy 21 and four of sex chromosome aneuploidy (SCA). The sensitivity and specificity for trisomy 21 were 100% (95% CI, 56.1–100.0%) and 100% (95% CI, 99.8–100.0%), respectively. The positive predictive value (PPV) for SCA was 40.0% (95% CI, 13.7–72.6%). No false negatives were found, with a negative predictive value (NPV) of 100% (95% CI, 99.8–100.0%) in total. In 32 pregnancies who failed NIPS test without available NIPS outcomes due to low fetal fraction, the regression analysis demonstrated that increasing BMI and assisted reproductive technology treatment were significant independent predictors. Conclusions NIPS is a high-performing routine primary prenatal screening test in twin pregnancies, with a high PPV and low false positive rate for detecting trisomy 21. It is also useful to identify common sex chromosome aneuploidies in twin pregnancies, with similar performance to that reported in singleton pregnancy.

Point-of-Care Quantification of Serum Alpha-Fetoprotein for Screening Birth Defects in Resource-Limited Settings: Proof-of-Concept Study.

Background:Maternal serum alpha-fetoprotein (MSAFP) concentration typically increases during pregnancy and is routinely measured during the second trimester as a part of screening for fetal neural tube defects and Down syndrome. However, most pregnancy screening tests are not available in the settings they are needed the most. A mobile device–enabled technology based on MSAFP for screening birth defects could enable the rapid screening and triage of high-risk pregnancies, especially where maternal serum screening and fetal ultrasound scan facilities are not easily accessible. Shifting the approach from clinic- and laboratory-dependent care to a mobile platform based on our point-of-care approach will enable translation to resource-limited settings and the global health care market.Objective:The objective of this study is to develop and perform proof-of-concept testing of a lateral flow immunoassay on a mobile platform for rapid, point-of-care quantification of serum alpha-fetoprotein (AFP) levels, from a drop of human serum, within a few minutes.Methods:The development of the immunoassay involved the selection of commercially available antibodies and optimization of their concentrations by an iterative method to achieve the required detection limits. We compared the performance of our method with that of commercially obtained human serum samples, with known AFP concentrations quantified by the Abbott ARCHITECT chemiluminescent magnetic microparticle immunoassay (CMIA).Results:We tested commercially obtained serum samples (N=20) with concentrations ranging from 2.2 to 446 ng/mL to compare the results of our point-of-care assay with results from the Abbott ARCHITECT CMIA. A correlation of 0.98 (P<.001) was observed on preliminary testing and comparison with the CMIA. The detection range of our point-of-care assay covers the range of maternal serum AFP levels observed during pregnancy.Conclusions:The preliminary test results from the AFP test on the mobile platform performed in this study represent a proof of concept that will pave the way for our future work focused on developing a mobile device–enabled quad-screen point-of-care testing with the potential to enable the screening of high-risk pregnancies in various settings. The AFP test on the mobile platform can be applied to enable screening for high-risk pregnancies, within a few minutes, at the point of care even in remote areas where maternal serum tests and fetal ultrasound scans are not easily accessible; assessment of whether clinical follow-up and diagnostic testing may be needed after a positive initial screening evaluation; and development of surveillance tools for birth defects.

Urine qRT-PCR assay as a screening tool for the detection of congenital human cytomegalovirus infection of infants

Congenital cytomegalovirus (CMV) infection is the most common infectious cause of birth defects. It may cause both, immediate and long term health problems in infants. These include variety of symptoms, such as hearing loss, microcephaly, jaundice, hepatosplenomegaly and seizures. In more severe cases CMV infection can cause the death of an unborn baby and loss of pregnancy. Despite being one of the most extensively studied vertically transmitted infections recently, the adverse effects of vertically transmitted CMV infection are still not well presented to the general public, resulting in a low awareness among potential expectant mothers in Bosnia and Herzegovina. This study aims to elucidate the sensitivity of urine samples for CMV detection in infants as well as to reflect the importance of quantitative real-time PCR (qRT-PCR) in diagnostics of CMV infection in infants. qRT-PCR was used in this study as a technique for the screening of CMV DNA in a cohort of patients based in Sarajevo Canton. These results have shown that urine samples are sufficiently sensitive for the detection of CMV DNA in infants. Furthermore, the simultaneous analysis of several patients has shown a higher number of CMV DNA copies amplified in urine compared to blood samples, derived from the same patient, thus proposing urine as a reliable sample of choice for congenital CMV diagnostics. These findings may propose a need to classify qRT-PCR CMV test among one of the recommended first-trimester pregnancy screening tests, which could help in early detection of CMV infection in Sarajevo Canton.

The effect of oral micronized progesterone on first trimester screening test markers and neonatal outcome

Objective: It was aimed to investigate whether or not nuchal translucency(NT) thickness, maternal serum free beta-human chorionic gonadotropin(β-hCG) and pregnancy-associated plasma protein-A(PAPP-A) levels may affected by the use of oral micronized progesterone(OMP) in first trimester pregnancies. Also we aimed to evaluate pregnancy outcome in pregnant women using OMP. Method: This study was performed retrospectively including 1192 pregnant women, between January 2015 and August 2017. Body mass index(BMI), maternal and gestational age, levels of maternal serum PAPP-A and free β-hCG, NT measurement and the crown–rump length(CRL), fetal sex, fetal birth weight, Apgar score 5thminute<7 and admission to neonatal intensive care unit(NICU) were evaluated. Results: Maternal characteristics, ultrasound and biochemical parameters, fetal characteristics and neonatal outcome were evaluated. There was no statistically significant difference for maternal age, BMI, gestational age, PAPP-A, β-hCG, CRL, NT thickness, fetal sex, fetal birth weight, Apgar score 5th minute <7 and the number of admission to NICU during the first 28 days. Conclusions: Our results suggest that in clinical practice, 1) it seems that using OMP cannot affect on NT, CRL and birth weight. 2) OMP cannot adversely affect on production of PAPP-A and β-hCG in vivo. 3) NT, serum PAPP-A and β-hCG levels and MoM values, which are markers of the first trimester screening test, do not change by using OMP. Therefore using OMP cannot affect reliability of the first trimester screening test in pregnancy with threatened abortion. 4) OMP does not look like adversely affect on poor neonatal outcome.

Antenatal screening for chromosomal and genetic abnormalities:Cost effectiveness and outcome

Introduction: As an essential part of antenatal care, pregnant women of all ages should be offered screening for chromosomal abnormalities before 20 weeks of gestation. This study was aimed to evaluate the type and frequency of chromosomal abnormalities following pregnancy screening tests, so that we can compare the actual pregnancy outcomes with test results, helping us in practical decision making. Methods: A cross-sectional study was conducted on 557 pregnant patients, presenting for prenatal diagnostic amniocentesis for chromosomal abnormalities, to Al-Zahra hospital, Tabriz, Iran, since 2012 to 2015. Amniocentesis was conducted by an expert obstetrician at second trimester between 16 and 22 weeks of gestation. An interview was set for pregnancy outcomes to assess the test results. Results: Of 557 cases, the mean maternal age in amniocentesis was 31.84 ± 6.92 years (range: 15-47 years). Amniocentesis revealed the presence of chromosomal abnormalities in 32 cases (5.7%). The most common diagnosed chromosomal abnormality was Down syndrome (50.0%) followed by other chromosomal abnormalities. Following up the patients, 92.4% of newborns did not have any congenital abnormality, but the remaining (7.6%) had both chromosomal and non-chromosomal abnormalities. No fetal loss was reported in this study. Assessment of total costs revealed that $US100 had been spent for hospitalization, and about $US500 for genetic tests. Conclusion: There is still no consensus on the most cost-effective strategy that should be implemented to diagnose chromosomal anomalies. Therefore, we did not have an actual gold standard to compare with amniocentesis. More studies analyzing natural outcome after prenatal diagnosis of these chromosomal abnormalities are needed

MHealth versus face-to-face: study protocol for a randomized trial to test a gender-focused intervention for young African American women at risk for HIV in North Carolina

BackgroundDisparities in the prevalence of HIV persist in the southern United States, and young African American women have a disproportionate burden of HIV as compared with young women of other racial/ethnic backgrounds. As a result, engaging young African American women in the HIV care continuum through HIV testing is imperative. This study is designed to reach this key population at risk for HIV. The study seeks to test the efficacy of two formats of a gender-focused, evidence-based, HIV-risk reduction intervention—the Young Women’s CoOp (YWC)—relative to HIV counseling and testing (HCT) among young African American women between the ages of 18 and 25 who use substances and have not recently been tested for HIV.MethodsUsing a seek-and-test framework, this three-arm cross-over randomized trial is being conducted in three county health departments in North Carolina. Each county is assigned to one of three study arms in each cycle: in-person (face-to-face) YWC, mobile Health (mHealth) YWC, or HCT. At study enrollment, participants complete a risk behavior survey via audio computer-assisted self-interview, and drug, alcohol, and pregnancy screening tests, and are then referred to HIV, gonorrhea, and chlamydia testing through their respective health departments. Participants in either of the YWC arms are asked to return approximately 1 week later to either begin the first of two in-person individual intervention sessions or to pick up the mHealth intervention preloaded on a tablet after a brief introduction to using the app. Participants in all arms are asked to return for a 6-month follow-up and 12-month follow-up, and repeat the survey and biological testing from baseline.DiscussionThe findings from this study will demonstrate which delivery format (mHealth or face-to-face) is efficacious in reducing substance use and sexual risk behaviors. If found to be efficacious, the intervention has potential for wider dissemination and reach.Trial registrationClinicalTrials.gov: NCT02965014. Registered November 16, 2016.

Low dose aspirin for preventing fetal growth restriction: a randomised trial.

Abstract The purpose of this study was to investigate when in pregnancy to stop the administration of low dose aspirin (150 mg/daily) so as to prevent fetal growth restriction (FGR) A randomised, placebo-controlled study was designed. The patients were all screened positive using the Fetal Medicine Foundation (FMF) early pregnancy screening test for preeclampsia (PE) and FGR prediction. One hundred and fifty patients were enrolled and divided equally into three groups: A – the controls who received placebo treatment; B – those who received aspirin till 32 weeks of gestation and C – those who received aspirin till 36 weeks of gestation. The mean gestational age at enrollment was similar for all the groups (12.4 weeks). The growth curves, fetal and maternal Doppler measurements and amniotic fluid index (AFI) were monitored every 4 weeks. Also, the outcome of the pregnancy was noted and all the results were compared between the groups. FGR was defined as a fetal weight below the 10th centile for gestational age. In group C, there were less cases of FGR compared with the other groups: 6% vs. 10% in group B vs. 24% in controls. Also, there was a significant birth weight improvement in this group with a median of 3180 g compared with 2950 g in group B and 2760 g in group A (P=0.01). The gestational age at delivery was similar in all the groups (39 weeks in group C/39.2 weeks in group B/38.6 weeks in group A). In conclusion, low dose aspirin improves the outcome in the selected population and should be offered for prevention of FGR from 12 to 36 weeks.

A study of the diagnostic value of Inhibin A Tests for occurrence of preeclampsia in pregnant women.

BackgroundHypertensive disorders are common during pregnancy, and are among 3 important causes of maternal death. Preeclampsia occurs in 3 to 5% of pregnancies. Early diagnosis of this disorder can lead to better pregnancy outcomes.ObjectiveThe aim of this study was to determine the relationship between inhibin A serum levels during second stage pregnancy screening tests, and incidence and severity of preeclampsia.MethodsIn this study, 300 pregnant women who referred to Kowsar Hospital and carried out second stage pregnancy screening tests from September 2014 to March 2015 in Urmia city, Iran, were enrolled. Five ml venous blood samples were obtained from each participant, and inhibin A serum levels were evaluated in all cases. Finally, all the necessary information was obtained from the pregnancy files of participants after delivery, and gathered in a questionnaire. The data were analyzed using SPSS software version 18 and independent t-test, ANOVA and descriptive statistics were used. P-values less than 0.05 were considered significant.ResultsAmong the 300 pregnant women who were studied, the gestational age at the time of acquiring blood samples was as follows: 169 cases (56.3%) at 16–17 weeks, 77 cases (25.7%) at 18–19 weeks and 14 cases at 20 weeks (4.7%). In this study, MOM of inhibin A was more than 1.25 in 12 cases that finally, preeclampsia occurred in them. This relationship was statistically significant (p=0.001). The relationship between MOM of inhibin A and severe preeclampsia was evaluated, and the relationship was significant (p=0.004). The relationship between MOM of inhibin A and pregnancy hypertension was not significant (p=0.643).ConclusionConsidering the results of this study, we can conclude that MOM of inhibin A levels in maternal serum during second stage pregnancy screening tests can predict incidence and severity of developing preeclampsia in pregnant women. This is not true in cases of pregnancy hypertension.

Non-invasive prenatal testing of pregnancies at risk for phenylketonuria

BackgroundPhenylketonuria (PKU) is a common metabolic disorder caused predominately by mutations in the phenylalanine hydroxylase (PAH) gene. The aim of the study was to design and validate the performance of...

The Outcomes of Pregnancy and Childbirth in Adolescents in Slovenia.

IntroductionThe objective of the study was to determine the course and outcomes of pregnancy and childbirth in adolescents compared to women aged 20–24 years in Slovenia.MethodsIn the retrospective study, the course of pregnancy and labour and the perinatal outcome of newborns in primiparous adolescents aged ≤19 years (study group) have been compared to the control group of primiparous women aged 20–24 years. The study group was further divided into a study subgroup of adolescents aged ≤17 years. Data were retrieved from the National Perinatal Information System in Slovenia for the period 2008–2012. Altogether, 13,663 women and their newborns were included.ResultsAdolescent pregnancy was associated with increased rates of unknown estimated date of delivery, preterm labour, low birth weight newborns, small for gestational age newborns and low gestational weight gain. Spontaneous labour was more common in adolescents, while emergency and elective Caesarean sections were less common than in women aged 20–24 years. In addition, pregnancy in adolescents aged ≤17 years was associated with increased rate of maternal anaemia and labour without complications. Higher rates of smoking, lower rates of parenting school attendance, lower rates of pregnancy check-ups and screening tests in pregnancy such as nuchal translucency in adolescents were found.ConclusionsThe results of the study show that adolescent pregnancy is related to higher health risks for pregnant adolescents and their newborns. In addition, adolescents are subject to poorer prenatal care comparing to older women.

Pregnancy screening prior to chemotherapy initiation: A retrospective review.

165 Background: ASCO’s Quality Oncology Practice Initiative (QOPI) sets site standards to promote excellence in oncology care. One standard is screening appropriate female patients for pregnancy prior to chemotherapy. However, no formal guidelines exist regarding pregnancy screening protocols or timing of screening. We believe that women are inconsistently being screened for pregnancy prior to chemotherapy. Methods: A retrospective chart review was conducted using the UF Health (UFH) tumor registry and electronic health record (Epic) to identify women ages 18-55 who received chemotherapy or endocrine therapy by a medical oncologist between January 1, 2012 and December 31, 2014. Exclusions were prior hysterectomy or tubal ligation, known pregnancy, or treatment outside of UFH. The following data was collected: age, race, diagnosis date, cancer type, pregnancy screening test (urine or blood β-HCG) and date, specialty of ordering provider, name of chemotherapy or endocrine agent, and participation in interventional clinical trial. Results: Our search identified 501 potentially eligible women. Of these, 204 were excluded, 96% due to prior hysterectomy or tubal ligation. Of the remaining 297 eligible women, 103 (35%) received pregnancy testing prior to chemotherapy. Three screening tests were positive of the 103 pregnancy tests ordered. Follow up testing revealed 2 were true positives and 1 was a false positive. Of the 103 pregnancy tests, 23 (22%) were ordered by medical oncology, 51 (50%) were ordered by a surgery or anesthesia, and 16 (16%) were ordered by emergency medicine. 48% of the pregnancy tests were performed within 14 days prior to treatment start date. Conclusions: At our institution, pregnancy screening rates in women of childbearing potential were just 35%, and less than half of the women who were screened received pregnancy testing within 14 days of treatment start. Based on this data, a quality improvement project has been initiated in the outpatient medical oncology clinic and infusion center to improve pregnancy screening in this population. [Table: see text]