The essential guide to ectopic pregnancy negligence

It is an unfortunate truth that not every pregnancy progresses as planned. An ectopic pregnancy is one example. If a pregnancy is ectopic then the baby can’t develop and subsequently will not survive. This situation can also have potentially devastating consequences for the woman if it is not identified and treated in a timely fashion.

Delay in determining and treating an ectopic pregnancy can be very dangerous and even fatal, and thankfully in the UK instances of this are rare. Nevertheless, whether delay is the result of a critical misdiagnosis or inappropriate treatment, it can have severe consequences, and may entitle a patient to significant compensation.

Here, we discuss what an ectopic pregnancy is, the risks involved if it is misidentified (particularly if this results in a rupture) and what steps a medical negligence expert should take to determine if your case was handled as well as it could have been.

What is an ectopic pregnancy?

An ectopic pregnancy is when an egg is fertilised outside of the uterus, most commonly taking place inside a fallopian tube. In this situation, although the egg is fertilised and will for a short time grow as a typical embryo would, an ectopic pregnancy cannot continue to grow outside of the uterus.

Sadly, there is no way to move the embryo to the uterus from this position, so it will need to be removed either naturally or directly through medicine or surgery.

Ectopic pregnancies are fairly rare, believed to affect 1 in 80-90 pregnancies, or approximately 11,000 pregnancies each year. However, if a woman has previously experienced an ectopic pregnancy, the chance of her having another rises to between 7% and 10%.

In many circumstances, it is not clear what the cause of an ectopic pregnancy is. However, certain risk factors have been identified that seem to make the condition more likely, including:

• Pelvic Inflammatory Disease (PID) – inflammation of the reproductive system, often caused by an STI
• Previous surgery on fallopian tubes
• Fertility treatments, such as IVF
• Pregnancy despite the use of an IUD or IUS for contraception
• Smoking
• Being aged 35 or older

However, ectopic pregnancies can affect any woman at any age.

The greatest danger surrounding an ectopic pregnancy is if it ruptures. A ruptured ectopic pregnancy is when the embryo grows to a size where it is simply too big for the fallopian tube. This can lead to significant internal bleeding and is potentially fatal if not identified and treated quickly enough.

Fortunately, ruptured ectopic pregnancies are treatable and deaths are extremely rare in the UK.

How do you identify an ectopic pregnancy?

It is possible for an ectopic pregnancy to develop for several weeks without any symptoms presenting themselves. If they do appear, this will typically occur between the 4th and 12th week of pregnancy, and may present in one or more of the following ways:

• Missed periods or other signs of pregnancy
• Lower abdominal pain
• Vaginal bleeding or brown, watery discharge
• Discomfort while urinating or defecating
• Pain in the tip of your shoulder

However, these symptoms are largely non-specific. This can lead to an ectopic pregnancy being misdiagnosed for a number of conditions that present similarly, including:

• Miscarriages
• Ovarian cyst haemorrhages, torsions or ruptures
• Urinary tract infections
• Appendicitis
• Diverticulitis
• Acute pelvic inflammatory diseases

Misdiagnosis is one of the primary causes of ectopic pregnancy negligence. Medical professionals must recognise the symptoms, ask relevant questions of their patients and perform any necessary tests to determine the true cause of the patient’s symptoms.

If an ectopic pregnancy is suspected, the following tests can be performed to confirm this diagnosis:

• Taking a pregnancy test
• A transvaginal ultrasound scan
• Blood tests to determine the presence of the hCG (Human Chorionic Gonadotropin) pregnancy hormone, and if this is behaving differently than in a normal pregnancy
• Performing a laparoscopy (keyhole surgery) to examine the womb and fallopian tubes directly

Symptoms of a ruptured ectopic pregnancy are more extreme and if identified should lead to immediate surgery to fix the issue. These symptoms include:

• Sharp, sudden and intense pains in the lower abdomen
• Feeling dizzy or fainting
• Nausea
• Looking very pale
• Signs of peritonitis (abdominal rebound tenderness and guarding)

Figuring out whether the actions of a medical professional were appropriate in response to these symptoms is an essential component of determining negligence in a ruptured ectopic pregnancy case.

The danger of misdiagnosed ectopic pregnancy

As highlighted, the most dangerous aspect of a misdiagnosed ectopic pregnancy is that, if it is not identified and treated soon enough, it can result in a rupture.

A rupture is not only very painful and traumatic for any woman that experiences it, but there is also the risk of severe blood loss and the fear of developing an infection like sepsis means that this incident can prove fatal for the patient.

Fortunately, cases of death as a result of a ruptured ectopic pregnancy are rare due to the attention to detail and proactiveness that medical professionals demonstrate on a day-to-day basis. But it is still a very real risk, and misdiagnosing an ectopic pregnancy for one of several symptom-sharing conditions like a miscarriage or appendicitis, can increase the chance of a rupture occurring.

Of course, it is important to note that one of the treatments for an ectopic pregnancy is expectant management. This is a case of closely monitoring the patient in the hope that the fertilised egg in the fallopian tube will resolve on its own. This indicates that not all instances of ectopic pregnancy require specific treatment to resolve.

However, in cases where either treatment through medication or surgery is necessary to remove the embryo before it can cause a rupture, a misdiagnosis of a suspected ectopic pregnancy can be critically unfortunate. As such, it is important that your GP, doctor or another healthcare professional asks key questions related to your fertility, menstrual cycle and overall health.

Treating a ruptured ectopic pregnancy

Prior to a rupture, an ectopic pregnancy can be treated either by:

1. Expectant management - closely monitoring the patient to identify if the fertilised egg will disappear naturally
2. Medication - the injection of a drug called methotrexate can prevent the embryo from growing further
3. A laparoscopy (keyhole surgery) - invasive surgery under general anaesthetic where a surgeon removes the embryo usually along with the affected fallopian tube

Once an ectopic pregnancy ruptures, surgery is the only possible treatment. This is important, as although sometimes surgery is the only available option before rupture, often an ectopic pregnancy can be treated in a safer, more convenient way through medication.

If a misdiagnosis or failure to treat the issue quickly enough due to negligence leads to an ectopic surgery requiring surgery, this not only carries the greater risks of invasive surgery and use of general anaesthetic, but can also result in:

• Surgery leaving a sizeable scar on the patient
• The loss of a fallopian tube that may have been preserved by medication, affecting a woman’s fertility and potentially requiring expensive IVF treatment to conceive in future
• The potential of the incorrect fallopian tube being removed, which could render the patient infertile
• Longer time off work and loss of earnings as compared to treatment with methotrexate or less invasive keyhole surgery

Establishing ectopic pregnancy negligence

Due to the nature of ectopic pregnancies, negligence can occur in a variety of ways.

It can occur in the misdiagnosis of the condition or a failure to react quickly enough to the present symptoms. In these instances, a medical negligence firm like Gadsby Wicks would rely on the expertise of their medical experts and a patient’s testimony of events to identify how evident their symptoms would have been at the times they met with a healthcare provider, and if more should have been done sooner.

If surgery is required to resolve the ectopic pregnancy, then there is also the possibility of a mistake at this stage such as the removal of an incorrect fallopian tube. While the instances are very rare, that does not mean it does not occur.

If you believe that you suffered unnecessary pain due to a misdiagnosis or poor treatment of your ectopic pregnancy, or a potentially avoidable surgery led to a significant loss of earnings, we can help you piece together what happened and secure the compensation you deserve.

Since 1993 our team has worked hard to support those through misdiagnosis claims, and the break of trust this can cause between a patient and medical professionals. We work closely with you to identify whether you have a claim, and then guide you through negotiations to secure the maximum compensation you are owed. In 98% of cases, our clients do not even have to enter a courtroom.

For more information, talk to our team today.

Disclaimer

All content contained within this article is meant for general information only – this should not be treated as a substitute for medical advice from your doctor or another healthcare provider. If you require legal advice specific to your situation, please contact our team directly.

Gadsby Wicks is not liable for any diagnosis made from the content of this article, nor does it endorse any service or external site linked to within the article.

Always consult your GP if you are concerned about your health and wellbeing, or speak to us if you require legal advice.