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Missed diagnosed ectopic pregnancy

When people hear about misdiagnosed pregnancies, they automatically think of misdiagnosed birth defects or missed diagnosed viable pregnancies. While those types of malpractice do occur in Pennsylvania and the U.S., one less commonly talked about problem is the misdiagnosis of viable pregnancies as nonviable.

According to a claim published in MDedge | ObGyn, a woman who was six weeks pregnant called her doctor regarding lower abdominal pain. When her doctor's partner performed an ultrasound, he could not locate an intrauterine fetus. He also noted that the woman's human chorionic gonadotropin levels were suggestive of an ectopic pregnancy. The next day the doctor performed an exploratory laparoscopy but found no evidence of the suspected ectopic pregnancy. He opted to remove the patient's appendix. 

However, even with the appendix out, the doctor continued to worry about an ectopic pregnancy. He suggested that the woman terminate the pregnancy via the use of methotrexate. A week later, a subsequent ultrasound revealed a fetus with a strong heartbeat. However, because methotrexate is a known cause of severe birth defects, the doctor again suggested the woman terminate the pregnancy. She did.

This woman's story is not uncommon. According to the New England Journal of Medicine, early diagnostic tests such as the measurement of hCG levels and ultrasonography, though crucial in the diagnosis and management of early-pregnancy issues, are routinely misused and misinterpreted. Such misinterpretation often leads to interventions that unintentionally harm pregnancies that might have had normal outcomes. The misdiagnosis of early pregnancies as ectopic is increasingly common and often has detrimental outcomes.

According to the findings, there are well-documented instances in which ObGyns have treated women with intrauterine pregnancies with intramuscular methotrexate for suspected ectopic pregnancy. Women who did not miscarry ended up giving birth to malformed babies. The findings further suggest that these types of incidences are far from rare. In addition to malpractice claims that cite this type of error, there are several online forums that offer support to women who are victims of this type of malpractice. 

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