Thursday, December 14, 2017
Health

Doctors search for reasons for ectopic pregnancy spike

TAMPA — The number of Florida women who died because of a pregnancy complication has gone up sharply, sending medical researchers on a search for answers.

In 2009-10, 11 Florida women bled to death due to an ectopic pregnancy — compared with 13 such deaths for the entire previous decade.

Ectopic pregnancy — when a fertilized egg implants outside of the uterus —accounts for less than 2 percent of all pregnancies in the U.S., but causes nearly 4 percent of maternal deaths.

The rate of such deaths has been declining nationally, thanks to rapid pregnancy testing and ultrasound technology that allows these pregnancies to be detected and ended before they lead to a ruptured fallopian tube and death from blood loss.

But in Florida, deaths appear to be on the upswing, and surprised experts think drug abuse, lack of prenatal care and unfamiliarity with this condition are all likely factors

"We were not expecting mortality from ectopic pregnancy to go up," said Dr. William Sappenfield, director of the USF Chiles Center for Healthy Mothers and Babies, and co-author of the report released by the U.S. Centers for Disease Control and Prevention.

An average of 54 women a year die in Florida of pregnancy-related causes, and all the deaths are investigated by the state Department of Health.

Six of the 11 Florida women who died in 2009-10 of an ectopic pregnancy tested positive for illicit drug use, mostly cocaine. "We think (drugs) contributed substantially'' to those deaths, Sappenfield said.

Why? Drugs are connected with risky lifestyle choices in general, which can mean increased likelihood of sexually transmitted diseases that can damage the fallopian tubes.

Plus, woman ashamed of their addiction often avoid doctors even when they're in pain, said another study author, Dr. Robert Yelverton, a Tampa obstetrician-gynecologist and medical director of Women's Care Florida.

Lack of prenatal care, whether related to addiction or not, is another likely factor. Most of the women who died had no health insurance. Most hadn't told anyone they were pregnant — and may not have known themselves since this condition occurs early in pregnancy.

"There were women in the study brought to the hospital dying from blood loss. That was the first time they had seen a physician," Yelverton said.

Some of the women died at home. Some made it to a health care facility, but weren't treated in time to save them. One died in an ambulance.

Most of the women had symptoms for more than 12 hours before collapsing, going into shock and dying. Some, according to family members, were in pain for 24 to 48 hours.

Sappenfield and Yelverton said that if more people understood what ectopic pregnancy is, deaths might have been averted.

The first sign is usually light bleeding, followed by abdominal pain. "Any pain with bleeding is a sign that the pregnancy is threatening to rupture," Yelverton said.

Most symptoms and death from ectopic pregnancy occur between 8 and 14 weeks gestation. Some may mistake the pain for bad menstrual cramps or a stomach bug. Even health care workers might not suspect ectopic pregnancy.

"The key is recognizing what's going on, suspecting ectopic pregnancy and quickly seeing a health care provider," said Sappenfield. "Any woman of childbearing age who has been sexually active and develops moderate to severe belly pain, especially if she missed a menstrual period, needs to consult with a health care provider."

Contact Irene Maher at [email protected]

Comments
Florida hospitals call for more funding in effort to address looming doctor shortage

Florida hospitals call for more funding in effort to address looming doctor shortage

The number of doctors practicing in Florida has not kept up with the state’s surging population growth, and more money is needed to recruit and keep them here, hospital leaders said Wednesday.The shortage is particularly acute in four speciality area...
Published: 12/13/17
An overlooked epidemic: Older Americans taking too many unneeded drugs

An overlooked epidemic: Older Americans taking too many unneeded drugs

Consider it America’s other prescription drug epidemic.For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 per...
Published: 12/13/17
How is Florida’s health? Not so great, report says

How is Florida’s health? Not so great, report says

Florida slightly improved its national standing this year, rising from 36th to 32nd overall in the annual America’s Health Rankings report. But the takeaway for the nation’s third-largest state is that it has a long way to go in many important health...
Published: 12/12/17
Driven by demand, Planned Parenthood opens second clinic in Tampa

Driven by demand, Planned Parenthood opens second clinic in Tampa

The floor-to-ceiling glass windows are heavily tinted and the inside is hidden behind rows of curtains. Security cameras monitor every corner, and only patients with an appointment and valid identification can pass through the intentionally cramped e...
Published: 12/12/17
Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Jimmy Kimmel was absent from his ABC late-night show last week while his 8-month-old son, Billy, recovered from his second heart surgery. Ever since Billy was born with a heart defect and required immediate surgery, Kimmel has become an outspoken adv...
Published: 12/12/17
Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

With just four days left to enroll for health insurance on the federal exchange, advocates for the Affordable Care Act say Florida is headed for a record-breaking year. In week five of the six-week open enrollment period, about 823,180 people signed ...
Published: 12/12/17
A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

While fighting back tears, young Keaton Jones couldn’t stop asking one question: Why?"Just out of curiosity, why do they bully? What’s the point of it?" he asks his mother while in the passenger seat of a parked car. "Why do you find joy in taking in...
Published: 12/10/17
Updated: 12/11/17
Legalization of marijuana for adults poses problems for people dealing with teens

Legalization of marijuana for adults poses problems for people dealing with teens

WESTMINSTER, Calif. — After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana.The 14-year-old took the class again this year but worries ...
Published: 12/10/17
Millions gained coverage since Obamacare, but many are worse off as premiums soar

Millions gained coverage since Obamacare, but many are worse off as premiums soar

As open enrollment for Affordable Care Act coverage nears the deadline of Dec. 15, and Florida once again leads all states using the federal exchange at healthcare.gov, Heidi and Richard Reiter sit at the kitchen table at their Davie home and struggl...
Published: 12/10/17
A gift of hands: After loss, a man finds hope from healing ones (w/video)

A gift of hands: After loss, a man finds hope from healing ones (w/video)

ST. PETERSBURG — Francisco Piedra fixed his eyes on the man sitting beside him. His name was Richard Brown, and in his hands he held Piedra’s new ones.The prosthetics were black and plastic. Each one took about 20 hours to build from a 3D printer. Pi...
Published: 12/08/17