Normal Pregnancies May Be Misdiagnosed as Ectopic

FRIDAY Jan. 13, 2012 -- Women with normal pregnancies that were misdiagnosed as ectopic who were treated with methotrexate in the first trimester either miscarried or gave birth to a severely deformed baby, the results of a small study suggest.

An ectopic pregnancy is one where the egg begins to develop outside the womb, which means that the fetus cannot grow normally and will not survive. The drug methotrexate (Rheumatrex, Trexall), which is used to treat rheumatoid arthritis and certain types of cancer, is also known to be dangerous to developing fetuses and can end an ectopic pregnancy.

Researchers affiliated with the Organization of Teratology Information Specialists (OTIS) cautioned that their findings, published in the December issue of the American Journal of Obstetrics & Gynecology, may be a red flag for a larger problem. They said more effective tools are needed to properly diagnose ectopic pregnancies.

"This report describes a subset of cases that occur in the general population and it suggests that this misdiagnosis is not limited to one center or one part of the United States or Canada," Sharon Lavigne, study co-author and coordinator of OTIS' Connecticut affiliate, said in a news release from the organization. "There are likely many more of these scenarios out there that our services never hear about," she added.

For the study, the researchers examined eight North American women with normal pregnancies that were misdiagnosed as ectopic. The women were given high doses of methotrexate, which resulted in miscarriage, termination of the pregnancy or the birth of severely malformed babies. The investigators concluded that more accurate and effective tools are needed to diagnose and treat ectopic pregnancy.

"This is a challenging diagnosis, and efforts to accurately locate the pregnancy in suspected early ectopic pregnancies would benefit from improved diagnostic tools," another study co-author, Myla Moretti, assistant director of Motherisk, OTIS' Canadian affiliate, explained in the news release. "Establishing a non-punitive reporting mechanism to explore the magnitude of this problem will be helpful in increasing awareness and possibly preventing these events in the future."

More information

The U.S. National Institutes of Health has more about ectopic pregnancy.

Posted: January 2012


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