Peter Baklinski

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Study: ‘catastrophic outcomes’ when ectopic pregnancies misdiagnosed, ‘treated’ with abortion

Peter Baklinski

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.”



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