Another baby survives ectopic pregnancy

Fox News in Phoenix has this story of a woman who was diagnosed with an ectopic pregnancy (one outside the uterus) at 20 weeks. She rejected surgery at that point because her baby couldn't have survived. He was born, healthy but premature, at 32 weeks.

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.

Live abdominal pregnancy presenting as massive rectal bleeding: "A case of massive rectal bleeding resulting from the placental attachment of an abdominal pregnancy to the sigmoid colon is reported. Both mother and infant survived this rare complication which should be considered when abdominal colic and major gastrointestinal haemorrhage occur in a pregnant patient."

Abdominal pregnancies, Primary Surgery: Volume One: Non-trauma, Chapter 8. The surgery of pregnancy: Covers a case of survival, with recommendations for management.

Massive hemorrhage in a previously undiagnosed abdominal pregnancy presenting for elective Cesarean delivery: Not sure if this is a new case or not.

Abdominal pregnancies in Sweden resulting in live infants 1970-81: The site is just a cite for an article in Swedish, leaving me to wonder how many infants were born alive after abdominal gestation just in Sweden in those 11 years.

Full-term viable abdominal pregnancy: a case report and review: A full-term abdominal pregnancy culminating in the birth of a live healthy baby by laparotomy is described.

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.

Rare baby survives outside womb: Montreal doctor, CBC News Tuesday, August 12, 2003: Dionne Grant, a Jamaican tourist, was in Montreal when she had to go to Sacré-Coeur Hospital for an emergency c-section, performed by Dr. Robert Sabbah, head of obstetrics and gynecology. He said, "When I opened the cavity I quickly discovered that the uterus was not like it was supposed to be. As soon as I explored the abdominal cavity I noticed there were feet in the cavity just floating around. So as fast as I could I took out the baby." The placenta had attached to the top of Dionne's uterus, this providing a good blood supply to the baby.

Here is an old medical journal article, ADVANCED EXTRAUTERINE PREGNANCY, Bulletin of the Hong Kong Medical Association, vol. 22, 1970. 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.