Posted on 09/07/2011 4:25:01 PM PDT by wagglebee
TORONTO, ON September 6, 2011 (LifeSiteNews.com) - Alarming research from The Hospital for Sick Children in Toronto has detailed the “catastrophic outcomes” that occur when ectopic pregnancies are misdiagnosed and then “treated” with chemical abortions – something the authors say amounts to a “serious public health issue.”
Citing previous studies, the new study reveals that a full 40% of initial diagnoses of ectopic pregnancy are erroneous, although it is unclear how many of these are ultimately mistreated as ectopic.
An ectopic pregnancy occurs when the developing baby lodges in the mother’s fallopian tube instead of her uterus. The growing baby may rupture the blood vessels of the fallopian tube, causing severe blood loss and even death to the mother.
The study, “Outcome Following High-Dose Methotrexate in Pregnancies Misdiagnosed as Ectopic,” which is to be published in the American Journal of Obstetrics and Gynecology, tracked a number of mothers with normal, desired pregnancies, who were erroneously given high doses of Methotrexate in their first trimester to end a misdiagnosed ectopic pregnancy.
The study describes how all the misdiagnosed pregnancies ended with “catastrophic outcomes,” including the births of “severely malformed” newborns, miscarriages, and physician-advised deaths of the normally implanted babies through surgical abortions on account of the adverse effects of Methotrexate on the pre-born baby.
In the cases of the three women who subsequently underwent surgical abortions, their physicians advised the mothers to abort for fear of potential “medico-legal repercussions ensuing from adverse fetal outcome,” said the study.
All the mothers in the study reported “significant emotional suffering as a result of the misdiagnosis and dire outcomes.”
After outlining the messiness and horrors of Methotrexate as the standard method for dealing with ectopic pregnancies, the researchers conclude only that physicians should ensure that Methotrexate be used within the “correct therapeutic time window,” and that steps be taken to ensure more accurate diagnoses.
LSN contacted lead researcher Dr. Laila Nurmohamed in Toronto for comment, but she declined the request for an interview.
Dr. Nicholas Tonti-Filippini, professor of Bioethics and Philosophy at the John Paul II Institute in Australia, told LifeSiteNews.com that the use of Methotrexate is a direct assault on the embryo and should never be used under any circumstances.
“I would not advocate the use of Methotrexate in the circumstances of pregnancy at any time. It is a poison which has … no legitimate purpose in relation to treating ectopic pregnancy.”
“It is a disaster to give a woman Methotrexate during pregnancy,” he said.
The FDA states that Methotrexate, which is also used in cancer treatments and in treating other conditions, in addition to inducing abortions, “interferes with DNA synthesis, repair, and cellular replication.” It especially affects tissues that increase rapidly in numbers such as “fetal cells.” Methotrexate has been reported to cause “fetal death and/or congenital anomalies,” and is “not recommended for women of childbearing potential.”
When asked if there is a better moral alternative for treating ectopic pregnancies, Dr. Tonti-Filippini pointed to recent studies that indicate that eighty percent of mothers with ectopic pregnancy will experience spontaneous resolution, with no medical intervention. The appropriate initial approach, he said, is one of “expectant management” in which the circumstances are observed until the gynaecologist determines that the woman is at risk of haemorrhaging.
“If she is at risk of haemorrhaging, which is life-threatening, it is at that stage legitimate to intervene in order to treat a life-threatening condition.” This becomes the “active management” stage of an ectopic pregnancy.
Pro-life ethicists have argued from the ethical criteria of “double-effect” that certain medical procedures are permissible to save the life of a mother with an ectopic pregnancy who is at risk of bleeding to death from a ruptured fallopian tube, even though the procedure may cause the unintentional and indirect death of the unborn child.
Tonti-Filippini said that a salpingectomy, which involves removing the segment of the fallopian tube containing the embryo, is a morally permissible means of dealing with a life-threatening ectopic pregnancy. In this procedure, the goal is to remove the life-threatening length of tube which carries the embryo, while the death of the embryo is an unintended side-effect.
In the case of the use of Methotrexate, said Tonti-Filippini, there is an intentional killing of the embryo, while with a salpingectomy there is an “effort to save the mother’s life, that indirectly affects the embryo.” Because of this, salpingectomy is a “legitimate and effective treatment for ectopic pregnancy,” said Tonti-Filippini.
With the research reporting such high numbers of misdiagnosed and mismanaged ectopic pregnancies, Tonti-Filippini said he would like to see “a greater call for training of ultrasonographers so that they can better identify ectopic pregnancy.” He also says he hopes that physicians will “adopt a more cautious approach than using Methotrexate.”
Freepmail wagglebee to subscribe or unsubscribe from the moral absolutes ping list.
FreeRepublic moral absolutes keyword search
It sure doesn’t look like they’re trying very hard to limit this to the genuine ectopic cases. No way of putting a scope in there and looking?
Thanks for posting this.
This doesn’t make any sense. When methotrexate is given, properly, the embyryo is already dead. HCG titers are followed. In a “normal” intrauterine pregnancy the level of HCG typically doubles every 48hrs. In ectopics it levels out as the placental tissue dies from lack of blood supply and room to grow. Plus, if an ultrasound is done one sees either an intrauterine pregnancy or not. If not you follow the titer. To do nothing does have significant risks if you make the wrong call. Not a good choice in this legal climate.
You can locate the pregnancy by ultrasound. Someone I know ended a much wanted but tubal pregnancy with Methotrexate, told by her doctor that that would better preserve her fertility than surgery. It went without complications and she later had two successful pregnancies.
The Catholic teaching here, that it is permissible to remove the section of the tube that is on the verge of rupture, along with the embryo and placenta, but that it is not permissible to surgically remove the embryo and placenta only, seems to me sophistical.
I understand that the about-to-rupture tube is viewed as pathological, and that its removal and the unintended effect on the baby is proportional to the saving of the mother, but one could also view the location of the pregnancy as pathological, and its removal from that location to be equivalent to removing the tube.
It is a genuine emergent condition and women die, and die quickly and suddenly. It is also a big malpractice risk.
This is not a winner, pro-life folks. I'd advise not picking this battle because you'll be fighting your allies in the medical profession. You'll just back normal doctors into a risk-averse corner.
Planned Parenthood makes no money--no money--off ectopic pregnancies.
And, no, there generally isn't a lot of time to do scoping, etc.
Not a winning battle, waggle. See post above. You cannot rescue a baby in a fallopian tube, but you can watch a woman bleed quickly to death once it ruptures—and before surgery can repair the rupture.
I’d be curious what, if anything, the methotrexate does to the ovary’s ability to produce healthy egg cells.
The most bothersome thing is the doubtful cases that the docs throw the methotrexate at without any further look, and end up at “best” killing off a normally located pregnancy and at worst producing a crippled, malformed child.
The hemorrhaging can kill quickly. At that point, there isn't a baby to save.
Pressure like this article causes doctors to form defensive ranks and hurts medical care for all women and other people. Ectopics do not go to Planned Parenthood, they go to the ER. They have no financial interest in abortion.
This is not a well-guided policy for the prolifers, to associate ER personnel with abortionists.
It’s a cancer drug.
Don’t get hung up on the specifics of the emergency, about-to-rupture situation which is neither here nor there.
The major point is this — if the woman isn’t on the verge of rupturing — if there’s time to give methotrexate and let it kill off the purportedly ectopic fetus — well, there’s time to look closely at the situation to see where the fetus really is physically located.
Which tells us nothing of the biological side effect upon immature egg cells....
Now, exactly what are you going to do with this article, written by a very romantic Canadian composer of music, and not a medical professional?
Do you really want doctors adding another layer of defensiveness when someone's life is at stake?
Ectopic pregnancies can lead to fallopian tube damage and infertility without any cancer drugs complicating the data or ova production. Frankly, that is an even better reason to use this drug proactively.
This doesn’t make any sense. When methotrexate is given, properly, the embyryo is already dead. HCG titers are followed. In a “normal” intrauterine pregnancy the level of HCG typically doubles every 48hrs. In ectopics it levels out as the placental tissue dies from lack of blood supply and room to grow. Plus, if an ultrasound is done one sees either an intrauterine pregnancy or not. If not you follow the titer. To do nothing does have significant risks if you make the wrong call. Not a good choice in this legal climate.
Agreed. This and another recent “Pro-life” post attacking all forms of Birth Control to such an extreme that most “common sense” Americans would find the arguments behind them illogical and absurd.
In standing against abortion, infanticide and active euthanasia, you have fairly well defined parameters and distinctives about the value of life, when it begins and ends, and what role humans are to play in that.
Ectopic pregnancies are real, they are direct and emergent threats to the life of women, and the conceived but unborn child cannot survive. In the same way, Birth Control — the prevention of pregnancies — is an issue of personal liberty, becuase it does NOT involve the fundamanetal “Right to Life” of an unborn child. While that MIGHT be my religious dogma (or yours) it is not Constitutionally or legally relevant.
But once a life is conceived — THAT has ultimate relevance, and remains so until the individual draws their last natural breath and their heart beats the last time.
If I have a week to determine if my toe needs to be amputated, surely that means a different approach than if I have five minutes.
Yavol, Herr Doktor. LoL. I'm just so pleased that you'll set protocols for women presenting at the ER with these symptoms.
Not.
The presentation of pain and bleeding, associated with a suddenly positive pregnancy exam, means that other drugs and treatments will be used to stabilize the patient. Then the drug is used to stop the progress.
This means the damage stops, gives time, and saves the tubes. And, fertility.
The world is not perfect, and there are probably misdiagnoses. However, an ER that fails to diagnose an ectopic in a timely fashion will absolutely get sued.
If you don't want your women to get treated for ectopics, keep them home and watch them die. Prolifers, and I am one, would do well not to become intoxicated with success and start picking green fruit from the top of the tree. Planned Parenthood has just had some real blows to their enterprise. Don't blow it. That's a good way to lose support.
And Herr Nurse, I’m sure you’ll just throw methotrexate at any case of suspected ectopic pregnancy in which the woman has enough time to take the drug and let it kill off the fetus. Heil!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.