Question about ectopic pregnancy

[Wendi]

Is it possible for a tubal pregnancy to move to the uterus and survive? I had always thought that a tubal pregnancy has no chance of survival, as well as being dangerous to the mother.

 

Thanks,

 

Wendi

[OnTheBrink]

A tubal pregnancy is when the baby implants in the tube. Most conceptions (sperm meeting egg) happens in the tube, and they move into the uterus to implant. If a baby implants in the tube, it will not move down into the uterus.

 

I may not be explaining this with the best terms, but that's how I understand conception to be.

[Jann in TX]

There have been a few RARE cases where the implantation took place just inside the tube--but the fetus/sack developed to term inside the uterus. This is still a VERY VERY high-risk situation for both baby and mother.

 

In most cases (99.9%) a tubal pregnancy will result in the tube rupturing and a life/death emergency for the mother.

[Wendi]

That's the understanding I had, too. But an acquaintance at church recently had a tubal pregnancy. She said people were advising her to have it "taken care of" (i.e., surgically removed), but she was praying that the baby would move or miscarry on its own. I was surprised, because when the doctor thought I had a tubal pregnancy many years ago, this was not presented as an option. Surgery (laparoscopy) to remove the embryo was recommended. (It turned out to not be an ectopic pregnancy after all.)

 

So I didn't know if this was medically possible, or if my friend was praying for a miracle.

 

Anyone else who wants to add to my understanding?

 

Wendi

[Melinda in VT]

There are rare, rare, rare cases in which a pregnancy outside the uterus (but not in the fallopian tubes) has resulted in a healthy baby.

 

I remember one such case from when we lived in Utah in the 1990s. I tried to Google it, but couldn't find it. I did find an article about a similar case in Canada in 2005. There was also a mention of implantation at the very end of the fallopian tubes where the fetus was in the uterus.

 

However, once a fetus implants, that's where it stays.

[Carrie12345]

That's the understanding I had, too. But an acquaintance at church recently had a tubal pregnancy. She said people were advising her to have it "taken care of" (i.e., surgically removed), but she was praying that the baby would move or miscarry on its own. I was surprised, because when the doctor thought I had a tubal pregnancy many years ago, this was not presented as an option. Surgery (laparoscopy) to remove the embryo was recommended. (It turned out to not be an ectopic pregnancy after all.)

 

So I didn't know if this was medically possible, or if my friend was praying for a miracle.

 

Anyone else who wants to add to my understanding?

 

Wendi

 

My pregnancy was caught immediately (I'm highly aware of my super conception powers ;)), so we weren't able to determine whether it was ectopic or not at first. Knowing my risk was high, and having no pain, I guess it was technically a pray/cross your fingers situation. But a confirmed ectopic? That's serious business.

 

My own situation involved months of confusion (suspected miscarriage, atypical hcg levels, etc.) but, once it was a visible, confirmed ectopic, there was no "hope for the best". And, even with treatment, I eventually wound up hemmoraging and having a full laparotomy. My only symptoms (other than the ultrasound evidence) were 2 incidences of severe drop in blood pressure (and all that comes with) that came without ANY warning.

 

There can be human error in reading ultrasounds. There can be anomolies in blood work. There can be an absence of symptoms. So I can understand and relate to early hope. But when it's there, it's a ticking time bomb that could easily kill a woman.

[LND1218]

My pregnancy was caught immediately (I'm highly aware of my super conception powers ;)), so we weren't able to determine whether it was ectopic or not at first. Knowing my risk was high, and having no pain, I guess it was technically a pray/cross your fingers situation. But a confirmed ectopic? That's serious business.

 

My own situation involved months of confusion (suspected miscarriage, atypical hcg levels, etc.) but, once it was a visible, confirmed ectopic, there was no "hope for the best". And, even with treatment, I eventually wound up hemmoraging and having a full laparotomy. My only symptoms (other than the ultrasound evidence) were 2 incidences of severe drop in blood pressure (and all that comes with) that came without ANY warning.

 

There can be human error in reading ultrasounds. There can be anomolies in blood work. There can be an absence of symptoms. So I can understand and relate to early hope. But when it's there, it's a ticking time bomb that could easily kill a woman.

 

:iagree:

 

About 50 women die every year from ectopic pg. It really isn't something to mess around with.

[Peek a Boo]

I agree that it would depend on where in the tube the pregnancy implanted.

 

I am rabidly anti-abortion, but if I knew i had a tubal pregnancy nowhere near the uterus, I would opt for aborting the pregnancy. They really are that serious. The baby WILL die - the best you can do is save the mom.

 

Actually, I would love to find a doc that would at least attempt to transplant it to the uterus, but I haven't even heard of one trying.

[Carrie12345]

 

Actually, I would love to find a doc that would at least attempt to transplant it to the uterus, but I haven't even heard of one trying.

 

The doctor who did my surgery (my mw's back-up obs' back-up ob, lol) believes it will be possible one day. Just not today!

[LND1218]

I agree that it would depend on where in the tube the pregnancy implanted.

 

I am rabidly anti-abortion, but if I knew i had a tubal pregnancy nowhere near the uterus, I would opt for aborting the pregnancy. They really are that serious. The baby WILL die - the best you can do is save the mom.

 

Actually, I would love to find a doc that would at least attempt to transplant it to the uterus, but I haven't even heard of one trying.

 

As wonderful as that would be, I am not sure it will be possible for a long time. In order to move the baby that it attached/implanted, you would have to cut it off it's lifesource - umbilical cord/placenta from the the mother to move it. I am not sure you could reattach it. Any part of the baby/sac/placenta left growing in the tube would kill the mother. So it all has to be removed.

 

And most of the time the baby is seriously underdeveloped - growth is so severely restricted when inside the tube that even if you could transplant without killing them they would likely die anyway. I have had 4 ectopics and only one was even close to being on track with growth - that was outside of the tube where there was room to grow.

 

Generally by the time they are caught around 6 or 7 weeks, they aren't doing well anyway. It's all very sad.

 

It does happen on occassion, like my one, where the growth is strong and on track, but it's rare. Add to that the risks of complications, infections, etc. I don't think we will see drs try this in the near future. It would be nice but it seems they have spent their time finding way to bypass the tubes with proceedures like IVF. So I don't expect to see this in my life time.

Edited April 6, 2009 by Steph

[Kimberly in IN]

An ectopic pregnancy can quickly become a life threatening (to mom) event. I experienced a ruptured ectopic, plus have one in utero at the same time. For a variety of reasons, the drs missed the ectopic b/c of the one in utero (apparently rare.) Anyway 24hrs after rupture, I was unconscious but apparently, dh was told to prepare for the worst, other drs in the group called our priest and my parents. Surgery saved my life and that of other baby. All in all, that pregnancy was a complicated event.

 

I truly understand hanging on to the hope of a successful pregnancy but a ruptured ectopic can be very dangerous. I would certainly, at least, give serious consideration to the medical advice given. If someone chooses not to have surgery, at least be prepared, have someone checking on her, etc. After a ectopic rupture, things can go downhill quickly.

[Wendi]

Everyone is confirming what I thought was true. My friend's comment really made me wonder. When my doctor thought I had a tubal pregnancy, I was at the ER (it was the weekend, and my OB docs were always at the hospital, so when I called with pain and bleeding (and a history of miscarriage), they had me come to the ER to check). The doctor had me stay in the hospital, and they did the laparoscopy there. He said that, before ultrasound, many women died of tubal pregnancies. So our understanding was that the baby had no chance of survival, and if not removed from the tube, I could die. Although we are strongly anti-abortion, we didn't question the decision. (Obviously, if the baby could have survived the situation, it would have been much more complicated.) As it turned out, the baby was not in the tube; it was a very early miscarriage with little tissue.

 

So when I was talking to this friend at church yesterday, she seemed surprised that several people "in the church" had told her to have a laparoscopy to remove the embryo. But she wouldn't do that, so she was praying that the baby would "move" or pass on its own. I commented that it was dangerous to the mom. Then I was dragged away to serve in the nursery, LOL.

 

So I was left wondering if I had been misinformed, or if the standard protocol for tubal pregnancies had changed since my experience 13 years ago. I didn't think my doctor would have pushed me into unnecessary surgery; I knew him well enough to know that wasn't his style.

 

Thanks for the info. If anyone else has anything to share, please do.

 

Wendi

[Soph the vet]

First hand experience here too. I had a ruptured ectopic, actually it aborted itself onto my ovary according to my OB and I was hemorrhaging profusely from the tube into my abdomen. Extreme abdominal pain and passing out were my first clues. In the ER I could feel fluid accumulating in my abdomen (yes, I know too much for my own good) and I kept hoping it was my appendix bursting, but it wasn't. As soon as I saw the ultrasound I knew I was headed for surgery. I had surgery in the middle of the night but thankfully my ovary was spared. I was almost a statistic and I am very thankful to be alive. God gave us two more children after that loss.

[BakersDozen]

One thing about waiting to see what happens...if an ectopic is caught early enough the tube might be able to be spared rather than removed. Had my idiot OB listened to me tell him a week before emergency surgery that I had an ectopic, had he ordered my hcg levels as STAT and not dragged his feet, I might have my fallopian tube left. :( There are so many tests that can monitor and diagnose an ectopic pregnancy now and save the tube, I personally would never advise a woman to "wait and see".

 

This thread makes me cry all over again even thought it's been 7.5 years.

[Impish]

First hand experience here:

 

I went to the clinic with what I later found out was classic signs of ectopic pregnancy, only to have them test me for a bladder infection :glare:

 

I started bleeding at the lab, rushed downstairs back to the clinic, and they told me I was miscarrying.

 

A few days and many tears later, I was still spotting, so I went to the ER thinking I needed a D&C, that the miscarriage wasn't complete.

 

They did an exam, said my cervix was still tightly closed, and I hadn't miscarried! I was overjoyed, called my almost husband (our wedding was a month away) only to get his vm on his cell...he was 4 hrs away on a business trip with his boss. They kept me in the ER for hours, drinking water so they could do an u/s to confirm that the pregnancy was viable, and figure out where the bleeding was coming from.

 

The u/s showed an 8-9 wk pregnancy in my left fallopian tube. Apparently, its pretty much unheard of to get to that point of pregnancy without rupture. Finally managed to get ahold of Wolf, and his boss managed to cut a 4 hr trip to 2 hrs. I went into shock. Surgery was a few hrs later, despite my trying to convince Wolf that we could just go home, and everything would be ok...I was in shock, remember?

 

Apparently, the surgery either missed something, or we got pregnant again right away, because my hcg levels didn't return to 0, so 2 days before my wedding I had an IV of methyltrexate (sp) a drug used in chemotherapy. It was horrible.

 

Thankfully, I've been able to have more children. Tazzie was born just before our 2nd wedding anniversary, and the Princess was born 19 mths and 7 days after Tazzie.

 

Ectopic pregnancies are nothing to mess with. The specialist told me that God was absolutely watching over me. By the time they started the surgery, the tube had begun to rupture. If I hadn't gone in when I did, thinking I needed a D&C, I would have ruptured at home...and died.

 

ETA: Despite my surgeon's doubts, they were able to do what's referred to as a 'conservative' surgery, and preserve the fallopian tube.

Edited April 6, 2009 by Impish

[Peek a Boo]

As wonderful as that would be, I am not sure it will be possible for a long time. .....So I don't expect to see this in my life time.

 

yeah... but I'd absolutely volunteer to be a guinea pig! If the baby's gonna die anyway, at least TRY darn it!! :glare:

 

and for OP:

 

PLEASE call as many people in your church --including pastors, elders, Titus 2 women, ANYONE-- and plead w/ them to advise her to seek medical care ASAP. Does she have other children?

 

I can absolutely appreciate praying for a miracle, and would likely seek three second opinions in quick succession before aborting, but these are veryveryvery dangerous.

 

good luck, to both of you.

:grouphug:

[OnTheBrink]

One thing about waiting to see what happens...if an ectopic is caught early enough the tube might be able to be spared rather than removed. Had my idiot OB listened to me tell him a week before emergency surgery that I had an ectopic, had he ordered my hcg levels as STAT and not dragged his feet, I might have my fallopian tube left. :( There are so many tests that can monitor and diagnose an ectopic pregnancy now and save the tube, I personally would never advise a woman to "wait and see".

 

This thread makes me cry all over again even thought it's been 7.5 years.

 

:grouphug::grouphug::grouphug: