Anti-cancer drug tackles some ectopic pregnancies

By MARTIN JOHNSTON Health reporter

Auckland doctors have proven the safety and effectiveness of using an anti-cancer drug to treat many women whose pregnancy develops outside their uterus.

These so-called ectopic pregnancies affect an estimated 1000 New Zealand women a year, of whom one or two die.

The embryo lodges in one of the fallopian tubes and occasionally in an ovary or the abdominal cavity.

Tubal pregnancies can result from a congenital abnormality or, if the tube is damaged, possibly from an infection.

The condition can lead to severe internal bleeding.

The standard treatment was to remove the embryo and often the tube by keyhole surgery.

Loss of a tube reduces fertility slightly and women with two damaged tubes can need in-vitro fertilisation to achieve a normal pregnancy inside the uterus.

But a study of 62 patients by three Auckland gynaecologists published in the latest British Journal of Obstetrics and Gynaecology shows that the anti-cancer drug methotrexate could be used successfully instead of surgery in up to a quarter of patients.

The drug destroys the embryo's placental tissue and the tube is left intact.

One of the gynaecologists, Associate Professor Cindy Farquhar, of National Women's Hospital and the Auckland Medical School, said yesterday that the drug was suitable for treating only those ectopic pregnancies which were in their early stages - most were detected between five and nine weeks after fertilisation - and in which there was no sign of internal bleeding.

Professor Farquhar said that while the drug caused hair loss and suppressed white blood cells in cancer sufferers, no side-effects were reported in the ectopic-pregnancy trial, where the drug was given at lower doses.

Treatment with the drug was $1600 cheaper than surgery.

Professor Farquhar knew of its use at several Auckland maternity units, including National Women's.

She said it was also widely used in the United States but not yet in Britain.