At this time the doctors and Fox News are reporting the case as unique. For the specific site of implantation, perhaps so. But little Azelan Cruz Perfecto isn't the only baby to survive an ectopic pregnancy.
Add this little fellow to the list. Valdir Gabriel was born in Brazil three months after his mother was diagnosed with an abdominal pregnancy, the type of ectopic pregnancy most likely to result in a live birth.
Case 1 was a 32-year-old mother of one, in 1956. "The extrauterine pregnancy was not diagnosed until 38th week when foetal movements could clearly be seen transmitted through the thin abdominal wall." She had no other symptoms that anything was amiss with her pregnancy. An X-ray showed that the baby was oddly situated, with an abnormally curved spine. She was immediately admitted to the hospital, where a 3,430 gram baby girl was delivered. The omentum (apron of fat covering the intestines) was covering the pregnancy, which seemed to have arisen in the right fallopian tube. There were only minor adhesions within the mother's abdomen. The mother recovered well, and had a successful normal pregnancy the following year. The baby was perfectly healthy.
Case 2 was a 41-year-old mother of two, who had slight bleeding at 16 weeks, and intermittent pain for four months. She was admitted to the hospital at 27 weeks. Her pain subsided after a week of hospitalization. The fetus could be easily felt through the woman's abdominal wall, as could the empty uterus. The patient refused immediate surgery, hoping to perserve her child's life. She remained hospitalized.
At 32 weeks she experienced sudden, acute abdominal pain. She was delivered of a 2,010 gram infant. The placenta had attached to the back wall of her pelvic cavity and the right broad ligament. The sac, placenta, and right fallopian tube and ovary were removed, with minimal blood loss. the mother recovered well. The baby had some facial asymmetry due to the unusual pressures placed on her from being gestated outside the womb.Case 3
was a 33-year-old mother of four, admitted to the hospital at 36 1/2 weeks because of recurring abdominal pain. The fetus was in breach presentation, but attempts to turn the baby by maniuplating it through the abdominal wall were unsuccessful. An X-ray revealed that the baby was lying transversely. The doctors decided to perform a c-section, whereupon they learned that the baby was actually behind the mother's uterus.The baby weighed 2,920 grams. The placenta had attached to the back of the mother's reproductive organs, which were removed. The mother recovered well and the baby was healthy.
Case 4 wasa 43-year-old mother of 8 who had been having abdominal pain since 12 weeks, and was admitted to the hospital at 26 weeks. Her uterus was displaced by the fetus, which was in her abdomen. Two days after she was admitted, she experienced sudden acute abdominal pain, so doctors performed surgery to remove the baby, a girl weighing 1,040 grams. Blood loss was minimal. The mother recovered well, and the baby had no problems other than prematurity. Sadly, she developed a respiratory infection and died at age 34 days.
And finally, in Australia, Durga Thangarajah was born at term after she had implanted in her mother's ovary -- a situation that doctors say is unheard-of. Or was until now.
24 Speak to me!:
Wow! That's amazing. I'm so glad the baby made it. I remember watching a TV show that had a woman who was pregnant with triplets, and one of them was ectopic, but she carried them all nearly to term (I seem to remember his placenta had attached to her bladder, or something?!) Sadly my ectopic baby didn't make it (classic tube implantation; the tube ruptured), but it's nice to hear it's not always a death sentence for the baby.
Yeah, myself, I'd risk it. I'm also wondering if women pushed harder for it, would doctors try to come up with ways to save babies that had implanted in the tubes? Perhaps you could carefully slit the tube under controlled circumstances so that it wouldn't rupture, then carefully move it to where it drapes across the top of the uterus to allow better access to blood for the fetus without risking placental adherence to her viscera.
If enough women started looking for other options, doctors would be forced to respond.
Great ideas, Christina. I wonder if we could get to the point where the baby could be moved into the uterus eventually. Amazing stories. Life is stronger than death.
Just like most things in life, it's easy to comment when you have not experienced it. Many of the above stories were about abdominal pregnancies not ectopic. I had an ectopic pregnancy back in 1998. The baby had implanted so far in my tube, my body didn't know it was even pregnant. The baby would not have survived. It's nice to speculate but please be sensitive to others. If you are going to offer solutions be prepared to put legs on the solution. Don't just offer words!
kristen, ectopic is outside the womb. It can be in the tube, in or on the ovary, on top of the uterus instead of in it, on the omentum or the intestines, etc.
And I realize that AS THINGS STAND NOW, we don't have the capability of intervening in a way that can save a baby in most ectopics. But there once was no way to save "blue babies", until Vivien Thomas and Alfred Blalock developed a surgery that was thought to be impossible.
a med school friend told me about a team of doctors that are looking into transplanting ectopic babies into the uterus. Obviously, this is in the very early stages of development but perhaps it might be a viable treatment method in years to come.
These cases are true miracles. Ectopic pregnancy is the most common cause of death in the first trimester of pregnancy. Rates of maternal mortality have dropped by over 50% since the 1980's secondary to earlier diagnosis. Even still, approximately 40-50 women die in the United States yearly from this problem. So while we have at best maybe 10 children and their mothers in all of history who have survived, please remember there are millions of mothers AND their unborn children who have died from this exact same condition. With the advent of minimally invasive surgery and methotrexate as therapies, there have not only been many maternal lives saved and their fertility spared. My point with the above: I guess when you make the statement that "if women pushed harder that doctors would come up with a way to save babies" and we would be "forced to respond" indicates that we don't value the sanctity of life and seems to minimalize how far we have come in saving lives! (Granted, it's not just us doctors who do the life saving...I believe that God is present in all we do.) I'm sure that was not your intent, however....I'm sure I'm not the only person reading this who had these same feelings and thoughts.
anon, if the women who WOULD choose to try to save their babies knew that it was -- however remotely -- possible, they would be the ones pushing for it until it became available at lower risk for other women, who would then push for even greater safety, etc., until saving these babies became doable, even if not common.
I'm not advocating that all women take an astronomical risk, only that doctors be willing to serve those who are willing, and that those women band together. I'd be one of them.
95-98% of all ectopic pregnancies are tubal pregnancies. There is NOT one tubal pregnancy that can be carried to full term! You cannot lump all ectopic pregnancies together. An abdominal ectopic pregnancy is VERY different from a tubal ectopic pregnancy. There is not sufficient room for a baby to develop to full term in the fallopian tube. If left untreated, the tube will rupture and the mother will die from hemmorhaging if not rushed to the hospital immediately. I'm just curious, Christina Dunigan, how many tubal pregnancies you have had?
Summer, I never said that any of these surviving babies were tubal pregnancies, and I never claimed that I'd had an ectopic pregnancy myself. I only asserted -- and only in the comments -- that were I to face any sort of ectopic pregnancy, I would try to carry to viability, and if the baby were in the tube I would try to find a doctor who would try to open and repostion the tube to prevent a spontaneous rupture an to try to encourage the placenta to attach to the outside of the uterus.
Other women -- few in number I will grant you -- have said that they would do likewise.
You will notice that none of us are asking other women to make that choice. But we are hoping that if there are enough of us, doctors will come up with a way to save these babies if their mothers ask for that high-risk option.
"How many ectopics have you had" was a facetious question. You obviously hadn't had any. You would really risk a tubal pregnancy?
Christina, your comments are very offensive and sophomoric and in no way helpful...I am a woman that has had 2 tubal pregnancies. As you are entitled to your thoughts, opinions, comments, etc, so am I.
Summer, yes I WOULD really risk a tubal pregnancy. I realize that this is a very rare stand, that it totally flies in the face of conventional medical wisdom, and that it would be an extremely risky thing.
Do I think EVERY woman would or should make that choice? Of course not. It would be a high-risk experimental procedure, and people aren't lab rats that you just do experiments on.
No you wouldn't. Do you know why it's a rare stand...because you are speaking hypothetically and therefore ignorantly. No one should ever remark on what they would do in an assumed situation because the truth is no one knows what they would truly do until they have walked in those shoes. You would never find your "dr to carefully slit your tube and drape it across your uterus" because this dr does not exist. But in your efforts to find this phantom dr, you would die in the meantime.....and now what a selfish decision you have made.
I am very curious to know how much research you have done on tubal pregnancies? Are you an OB/GYN? Surely you are making all these comments from a very informed stand, right? Please don't tell me everything you know is that which exists on Wikipedia or WebMD?
Of course it's hypothetical, Summer. Everything that becomes real starts out as hypothetical. Every medical treatment that is routine now started out as an experiment at some time.
You seem to be feeling like you're being judged for not having demanded medical experiments when you were diagnosed with tubal pregnancies. I don't know of anybody who is doing that. There are just a few people taking the information that sometimes, very rarely, but sometimes, babies survive when they implant outside the uterus, and putting firmly in their own minds that in the unlikely event that this happens to them, they will push for a medical experiment.
Would we actually follow through if push came to shove? As you've said, we can't really know. However, people ARE more likely to follow through on a plan they've thought through in advance -- especially a plan for doing something in a time of high stress.
Nobody, starting cold with no advance planning, is going to respond to a doctor saying, "We have to do X right away or you will die" with, "Well, let me spend a few years researching this, and maybe I'll decide that I want to be a guinea pig for a medical experiment!" The patient in that situation doesn't HAVE a few years.
That's why it's important for people to have the idea in the back of their minds, so that they start thinking of it. The first dozen women who ask a doctor will be told that they're insane, that it can't work, that there's no way any doctor will do it.
Then the doctor will start wondering. He'll start doing research in medical journals. Maybe he'll start something with lab rats or pigs.
Over the course of a few generations maybe they'll come up with something. That's what we're hoping for.
Why does it piss you off so much?
Ignorance is bliss, my dear Christina. You don't think there are dr's trying to come up with a way to save tubal pregnancies? You don't think there are hundreds of thousands of women asking and pushing dr's to find an alternative plan? "The first DOZEN women"...lmao!
And who said I was pissed?? Good grief!
Summer, you seem to be contradicting what you said earlier.
My perception is that you indicted that to even TRY to save a tubal pregnancy is utterly insane, no doctor would ever try, and no woman would be crazy enough to ask.
Now you seem to be saying that there ARE doctors trying, and that hundreds of thousands of women are pushing for it.
And obvsiouly you ARE pissed. I can amost feel you trying to reach through your monior and bitch-slap me every time you post.
Bless your heart.
If hundreds of thousands of women are asking doctors to save their ectopic pregnancies, and if doctors are trying to come up with ways to save these pregnancies, I'm wondering where the studies are that discuss it. I went to Google Scholar [scholar.google.com] and searched "ectopic pregnancy" and looked at the first 200 returns (20 pages); almost all of the studies were about diagnosing and treating ectopic pregnancies (via one method of abortion or another), incidence or trends of ectopic pregnancy in America and elsewhere, or risk factors for ectopic pregnancy, with *none* about how to save them. Some of the articles discussed how best to preserve the mother's fertility while aborting the baby, and there were some dealing with "expectant management" of ectopic pregnancy (taking a "wait and see" approach that you seem to denigrate as being lethal for the mom, even though about half did not require treatment, in every study), but none were about attempting to save the baby. There were case studies of women with ectopic pregnancies in a C-section scar, but no case studies of an attempt to save the baby of an ectopic pregnancy.
A recent (2006) study, (updated 2009) looking at "interventions for tubal ectopic pregnancy" failed to mention any attempt at removing and re-implanting the embryo/placenta, but discusses only expectant management and various methods of abortion.
If you know of any case of an attempt to save the baby in humans, or of any studies on ectopic pregnancy in animals with a view to attempts at saving the fetus either in the animal or as a test for humans, please let me know. Everything is impossible... until it's tried. Open-heart surgery used to be impossible, even unthinkable, until finally someone did it. Now it's fairly common. Remaining in the thought patterns of decades and centuries gone by is not the way to advance; imagining possibilities is.
Wow, if you you can't find anything on google, that must be the end all, say all. Lol.
Google Scholar is a bit different. It searches peer-reviewed journals and articles, and is a valuable resource for finding scholarly studies. But if it's as widespread and easy as you are implying it should be to find information on alternatives to outright abortion for ectopic pregnancy, you should be able to point to at least one of the hundreds of thousands of women who are demanding of their doctors alternative treatment, or at least one doctor that is undertaking the task.
[The Captcha phrase is sylly. Appropriate, I think.]
http://news.bbc.co.uk/2/hi/health/443373.stm
This is a link to successful TUBAL pregnancy. Odds were one in 60 Million but that still ends summers argument.
Summer said...
"95-98% of all ectopic pregnancies are tubal pregnancies. There is NOT one tubal pregnancy that can be carried to full term!"
Thanks, Pozzo!
I had seen this story a couple of times, but never read that the boy started as a tubal pregnancy before moving to and implanting in the outside of the uterus.
If that was the case (only slightly skeptical, knowing the average reporter's carelessness or ignorance regarding medical things), then that definitely shows that it is a possibility to medically/surgically move the baby from the tube to the uterus to grow, and abortion is not necessarily the only answer.
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