The Ectopic Pregnancy Trust has reported that one in 80 pregnancies will be ectopic and it can be a devastating experience not only for the mother but also for the father and their families. Over the past year there have been several reported cases of women who have suffered horrific injuries - or died - due to a failure to diagnose their ectopic pregnancies early enough.
WHAT IS AN ECTOPIC PREGNANCY?
An ectopic pregnancy is when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes. If an ectopic pregnancy is left to develop, there is a risk that the fertilised egg could continue to grow and cause the fallopian tube to rupture. Sadly, an ectopic pregnancy can never be a viable one.
In July 2014, the BBC reported on a Gloucestershire inquest which found that the death of a young British woman working in Cyprus was entirely avoidable after doctors failed to diagnose that her pregnancy was ectopic. She was taken to a private clinic screaming in pain with severe cramps and vomiting but doctors failed to spot the hallmark signs of an ectopic pregnancy and she died six hours later.
In February 2015, The Mirror reported on a case of a Californian woman who fell into a coma after her ectopic pregnancy was missed. She was 12 weeks pregnant when she suffered a ruptured fallopian tube and internal bleeding.
The Daily Mail reported in June 2015 that a coroner blamed inappropriate decisions, system failures and missed opportunities for the death of a young woman with an ectopic pregnancy who died from a heart attack after waiting two hours for an ambulance to arrive.
The Penningtons Manches clinical negligence team has dealt with a number of cases where clients have attended their GP or local hospital complaining of the typical signs of an ectopic pregnancy but have been turned away and told that everything is fine. In some cases, the failure to diagnose the ectopic pregnancy early leads to the rupture of the fallopian tube, internal haemorrhage and life-threatening consequences.
GREATER AWARENESS OF SYMPTOMS NEEDED
The signs and symptoms of ectopic pregnancies are all too often unnoticed and there is an urgent need for greater awareness of ectopic pregnancies and the signs and symptoms to look out for.
Some of our clients did not know what an ectopic pregnancy was so did not question the symptoms they were suffering or push doctors for confirmation that they did not have an ectopic pregnancy.
It can be very difficult to diagnose an ectopic pregnancy because the symptoms can often be mistaken for other conditions such as gastroenteritis, irritable bowel syndrome (IBS) or miscarriage. It is therefore very important to report all symptoms that cause concern and to be vigilant about these as this will hopefully help lead to an earlier diagnosis.
WHAT ARE THE SYMPTOMS OF AN ECTOPIC PREGNANCY?
Symptoms can include:
- A positive pregnancy test
- A missed or late period
- One sided abdominal pain which can be persistent or severe
- Spotting or abnormal vaginal bleeding – different to the type of bleeding during a regular period
- Pain when passing urine or stools
- Diarrhoea and vomiting
- Shoulder tip pain.
However, sometimes women do not experience any symptoms until the fallopian tube has ruptured. In these cases, early diagnosis can be extremely difficult.
HOW IS AN ECTOPIC PREGNANCY USUALLY DIAGNOSED?
The first test that can be offered is a blood test to measure the level of hormone human chorionic gonadotropic (hCG). The hCG levels will usually be lower than normal if a pregnancy is ectopic.
Often a transvaginal ultrasound scan will be used to assess the location of the pregnancy. If there is any doubt that the pregnancy is not intrauterine, it is accepted practice to repeat the blood tests to test the hCG levels again for more definitive levels.
If an ectopic pregnancy still cannot be confirmed, a laparoscopy may be performed. This involves inserting a viewing tube through a small opening in the abdomen to examine the womb and fallopian tubes.
When an ectopic pregnancy is diagnosed, surgery will be undertaken to remove the fetus or, more often, the fallopian tube itself, before it ruptures and causes potentially life-threatening complications.
This is why early detection of an ectopic pregnancy is so important.