Life-saving treatment for ectopic pregnancy depends on board that works till 2:30pm

A doctor wanting to administer methotrexate to end a woman’s life-threatening ectopic pregnancy requires approval from a government body that works until 2:30pm, MaltaToday has learnt.

If the paperwork does not arrive at the Directorate for Pharmaceutical Affairs before that time, approval will be given the next day, delaying the treatment by several hours.

The issue first came to light when Break the Taboo Malta, an online campaign platform showcasing stories of women affected badly by the total ban on abortion, published the story of a woman who was only administered the treatment two days after her ectopic pregnancy was diagnosed.

The woman had been told her treatment had to be approved by a board.

The Health Ministry reacted to the story, insisting that a request form for methotrexate is signed by the consultant and countersigned by the chairman of the Department of Obstetrics and Gynaecology, a procedure that usually took “a few hours”.

The ministry said no board oversees the process.

MaltaToday understands that from information sourced by a medical professional from a pharmacy, doctors would need to send an exceptional treatment form to the Directorate for Pharmaceutical Affairs by email, and the board there would approve the application and give the go ahead to the pharmacist to prepare the medication.

But the board works until 2:30pm and that if paperwork did not arrive to them by then, they would approve it the next day.

An ectopic pregnancy is life-threatening for the woman and methotrexate is administered to end the pregnancy and avoid further complications. The woman that flagged the issue lamented that her fertility and her life were “needlessly put at risk” because of procedural delays stemming from Malta's umbrella ban on abortion.

She said that because of the delay in treatment the first dose did not work, and she had to be re-admitted to hospital for another which eventually worked.

The blanket ban on abortion means that doctors cannot immediately administer treatment that ends the pregnancy.

The NGO Doctors for Choice said this was a consequence of Malta’s “pro-life abortion ban.” The NGO said that ectopic pregnancies needed to be treated urgently, and any delay in treatment could result in an increased risk of rupture which may cost the woman her life.

Meanwhile, anti-abortion group Doctors for Life yesterday accused the pro-choice group of misinformation by trying to capitalise on a patient experience to “advance an agenda”.

Doctors for Life said ectopic pregnancies can be fatal and have always been treated seriously by the medical professionals at Mater Dei Hospital.

“Proof of the excellent track record of our hospital is the fact that no pregnant mother has lost her life in the last 10 years.This is the result of a high level of professionalism as well as robust practices that always seek to protect the lives of mothers,” the group said, endorsing the ministry’s reply.

What is an ectopic pregnancy?

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes. The fallopian tubes connect the ovaries to the womb.

If an egg implants in them, it won't develop into a baby and the woman’s health may be at risk if the pregnancy continues. An ectopic pregnancy is life-threatening for the woman.

It's not possible to save the pregnancy and treatment usually involves the removal of the fertilised egg using medicine or an operation.