Any doctor worth his grain of salt always confirms the patient’s claims. And this is true, especially about pregnancy. Even if you go to a Dermatologist for acne and if she feels you need retinoids, she will ask you to undergo a pregnancy test. She knows that she cannot risk the life of an unborn child especially when all you have to do is pee on a stick. And, a good gynaecologist would always check for pregnancy before conducting a procedure like a hysteroscopy.
The botched hysteroscopy
According to a report, on August 23, an employee of the Taipei Chang Gung Memorial Hospital, Taiwan, went to a gynaecologist for a consultation. She was having what she thought was a menstrual disorder. In such cases, a gynaecologist may perform a hysteroscopy if it is medically indicated.
Before doing the procedure, the doctor asked the woman if she was using any contraceptives. She told the gynaecologist that she was using oral contraceptive pills. But instead of checking for the pregnancy, he just went ahead and performed the hysteroscopy. What the woman was unaware of was that she was 23 weeks pregnant. And the hysteroscopy procedure just lead to the premature birth of her baby!
But, the gynaecologist tried to cover it up. He urged the nurses to ignore the baby and tried to sweep the whole matter under the carpet. Apparently, the employee, feeling disgruntled by the whole situation, wrote a letter to the hospital management. It criticised the hospital of profiteering by advising unnecessary tests to patients. Apparently, hysteroscopy was offered to 90% of gynaecology patients, not in tune with the correct indications.
According to The Faculty of Sexual and Reproductive Healthcare and American College of Obstetricians and Gynecologists (ACOG, 2011) guidelines, insertion of intrauterine devices at any time if pregnancy can be reasonably excluded. Known pregnancy, genital tract infections, and active herpetic infection are contraindications to hysteroscopy. And, a Sonohysterography should not be performed in a woman who is pregnant or who could be pregnant.
Finally, on Friday, 15 September, it acknowledged that the procedure was the doctor’s fault. The doctor has been suspended pending investigation.
Unnecessary procedures
As hospitals scramble for profits, the patients end up suffering. However, in most of the cases, medicine is practised ethically in Singapore. There might be a few odd cases of an unindicated procedure being done here, but overall, the medical practice is uniform here. And that somewhat justifies the cost of healthcare.
However, it is not the case in many other countries. These countries, masquerading as ‘medical tourism’ havens, offer procedures at incredibly low prices. And, to be fair, many of these hospitals are state-of-the-art, with excellent doctors and facilities. The trouble is, the healthcare there is not uniform. You may be given a ‘package’ deal, that looks like a tour package! However, research well and talk to people before you hop on a plane to get that cheaper ‘body sculpting’!
So, research well and talk to people before you hop on a plane to get that cheaper ‘body sculpting’ or send your mother for a hip replacement.
Contraceptives and pregnancy awareness
Coming back to the story, the employee was unaware of the pregnancy. And the doctor even tried to blame her, saying that she should have known and told him. However, in many cases, women don’t realise about the pregnancy till they are well into the second trimester. The most common reason is a history of irregular menses in the past. In a condition termed oligomenorrhoea, the menses are more than 35 days apart. In some cases, the woman has only 4- 9 periods in a year. So, it is natural to miss a pregnancy, especially if the morning sickness is mild.
The last thing I would like to stress is, no contraceptive device is 100% proof. Condoms and oral contraceptive pills (OCPs) are most popular in Singapore. However, for mums who want to have a gap between two children, Intrauterine Systems are more effective. So, if you are in a steady, monogamous relationship, research for options like Hormone inserts and Intrauterine systems with your doctor.
To sum it up, be careful when you are getting healthcare outside Singapore, remember that pregnancies are possible despite the use of contraceptives, and don’t judge the woman. The doctor is the one at fault.
(Image is for representation purposes only.)
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