Checking pregnancy status of young girls in advance of radiological intervention – Time for a re-think?

Article 62 of European Council Directive 2013/59/EURATOM requires establishment of the pregnancy status of a female patient, in advance of radiology of the abdomen, unless it can be ruled out for obvious reasons or is not relevant. Children under the age of 15 years are a particularly vulnerable population when it comes to establishing their pregnancy status. They are generally, by necessity, questioned in the company of their parent or guardian which, in itself, is likely to inhibit a truthful answer. Furthermore, conversations regarding such matters require a degree of privacy not afforded by the vast majority of busy and over-crowded Radiology waiting rooms. No specific training exists in relation to how the subject is broached by staff performing the enquiry and as a result the questions are often phrased in a leading way. It has also been shown that many adolescents, in particular those less than 15 years of age, are emotionally incapable of thinking of themselves as sexually active. This, together with the fact that a percentage of patients presenting may be disabled, makes the entire process particularly difficult. We propose that the need to establish pregnancy status in this population be based on prevalence rate of pregnancy in the state. For example, in Ireland, live birth rates in teenage girls have been found to be an order of magnitude lower than the failure rate of common contraceptives. This, on its own represents an obvious reason to not require establishing pregnancy status in this population.