Rare Ectopic Pregnancy Deaths Rise Abruptly in Florida

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The rate of ectopic pregnancy deaths rose abruptly in Florida in 2009 and 2010, according to a new government report. Ectopic pregnancy is a rare condition where a fertilized egg implants in a woman's body in a place other than the uterus, such as in an oviduct.

There were 11 ectopic pregnancy deaths in Florida in 2009 and 2010; there were 13 deaths during the 10-year period between 1999 and 2008 in the state, according to the report.

That means Florida's mortality rate from ectopic pregnancy in 2009 and 2010 reached 2.5 deaths per 100,000 live births, climbing from 0.6 deaths per 100,000 live births for the years between 1999 and 2008, which was in line with the national mortality rate for the condition at the time.

The increase appears to be linked with illicit drug use and delays in seeking health care, the researchers concluded, after studying information surrounding the deaths.

Of the 11 women who died in 2009 and 2010, eight had collapsed prior to their deaths. Women with an ectopic pregnancy may collapse when an oviduct (also called a fallopian tube) bursts, leading to hemorrhaging, according to the report. Collapsing generally happens only when a woman has not received health care for earlier signs of an ectopic pregnancy. Autopsies of six of the women who collapsed detected illicit drugs in their systems.

Ectopic pregnancies are treatable with drugs or with surgery to remove the embryo, which cannot develop outside of the uterus, according to the Mayo Clinic.

The women who collapsed were from disadvantaged groups, who might have experienced difficulties accessing health care or did not have insurance, according to the report.  

In the early 1980s, the national mortality rate from ectopic pregnancy was 1.15 deaths per 100,000 live births; by 2007, it had fallen to 0.5 deaths per 100,000 live births, according to the report. The decline depended heavily on women having access to health care early in their pregnancies.

In Florida, among women without health insurance, the mortality rate rose from 1.8 deaths per 100,000 live births in the period between 1999 to 2008, but rose to 17.6 deaths per 100,000 live births in 2009 and 2010, according to the report.

Florida's rising mortality rate could be combated by ensuring early access to health care, promoting awareness about early pregnancy testing and ectopic pregnancy risk and raising public awareness about substance abuse health risks, according to the report.

The report was compiled by researchers at Florida's Pregnancy-Associated Mortality Review and the Centers for Disease Control and Prevention. It was limited in that the total number of deaths was small, and complete medical histories were not obtainable for every woman who died.

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