Watch: Ectopic pregnancy medication should be included on formulary – consultant obstetrician

Treatment not hindered by absence of abortion legislation

Tista' taqra bil- Malti.

The use of medication to treat ectopic pregnancies may be delayed as it requires the authorisation of a board which only convenes until 2.30pm, in what consultant obstetrician Ivan Galea recognised as a shortcoming of the present system.

Speaking on Saturday’s edition of Andrew Azzopardi on 103, however, Galea emphasised that the treatment of ectopic pregnancies was not being hindered by any moral dilemmas or conscientious objection.

Galea was speaking in the wake of a controversy which erupted when a woman with an ectopic pregnancy was reportedly denied immediate treatment, with Doctors for Choice stating that the woman was placed under unnecessary risk as a result.

He highlighted that ectopic pregnancies – which occur when a fertilised egg implants itself outside of a woman’s uterus, generally in the fallopian tubes – are relatively common. Around 30 such pregnancies occur in Malta each year, representing approximately 1-2% of all pregnancies.

Ectopic pregnancies are not viable and if left unaddressed, they can rupture the fallopian tube, leading to a haemorrhage which can possibly be fatal.

Galea highlighted that there were two main treatment options, with one of them being surgery. But medical treatment may also be possible, through the specialised medication methotrexate.

Board approval is required for medication but not for surgery.

However, methotrexate is not on the government formulary, and thus requires the approval of a specific board. Galea emphasised that the board did not solely concern itself with ectopic pregnancy.

But since the board only convenes until 2.30pm, any later requests would face delays. In light of the serious nature of ectopic pregnancies, Galea believes that methotrexate should be on the government formulary to avoid any unnecessary delays.

However, Galea also pointed out that ectopic pregnancies have been treated in Malta for the past 50 years, and that no moral dilemma or abortion debate was hindering treatment.

“The absence of abortion legislation has not hindered the treatment of such cases; this has always been the case and it will always remain so,” he maintained.