A prominent gynecologist in Connecticut has just been fined by the state’s medical examining board after he removed the uterus of a woman who was pregnant in 2011.
Jonathan Foster, M.D., says he didn’t realize the patient (whose name was not publicly disclosed) was pregnant before he performed a laparoscopic hysterectomy on her, the Hartford Courant reports. Pre-surgery, he conducted two urine pregnancy tests that said she wasn’t pregnant, but he never did a blood test or ultrasound to follow up.
Instead, he relied on the word of the patient, who insisted she wasn’t pregnant.
"Dr. Foster had a long discussion with the patient. … She represented that 'I am absolutely not pregnant,'" Foster’s attorney told the Hartford Courant. "We're not blaming her. This was a woman who wanted to move forward with the procedure."
Foster did not contest the findings. He paid a $5,000 fine and completed a course to maintain his certification.
Valerie Waddell, M.D., an ob-gyn from The Ohio State University Wexner Medical Center, says a urine pregnancy test is usually done before a hysterectomy to make sure the patient isn’t pregnant, along with a discussion about “contraceptive practices” in the two weeks before the negative test.
But here’s the problem: Any test can give a false positive…or false negative. “There is always a chance that the test could be defective and give false results,” says Waddell.
There’s also a chance the patient could have gotten pregnant less than two weeks before the pregnancy test, which a urine test wouldn’t have been able to pick up. “For this reason, the patient must also be asked how pregnancy has been prevented in the weeks leading up to surgery,” says Waddell.
Doctors do have the option of performing a blood test (which can pick up pregnancy earlier than a urine test) if there’s any doubt, though, she says, but that’s not the standard test used.
An ultrasound wouldn’t have been helpful either, she says, since nothing would have been visible at the time.
Pretty disturbing stuff, but this is obviously a very rare case. If you're considering a hysterectomy, it's never a bad idea to talk through which tests you should do beforehand to minimize your odds of complications—pregnancy-related or otherwise.