Trapped in the tube; babies that never make it to the womb

 “It started as a bad period with light bleeding, stomach upset, and abdominal cramps. As the days went by, vomiting, general body weakness, and dizziness set in.  Little did I know that I was bleeding internally as a result of ectopic pregnancy”, Efua Asiedua (not her real name) told GhanaPlus.com.

As a young lady, the thought of having difficulties with childbearing was never part of her worries.

However, as fate would have it, and as solely within the control of God’s power, there was nothing to show for her womanhood, as expected by society, after five solid years of marriage.

That notwithstanding, she was still hopeful that one day, she will carry her own child when the heavens permit and smile on her.

For years, she awaited this miracle but to no avail, only to be told on that fateful day at the hospital that she was bleeding internally from an ectopic pregnancy.

“I never knew I was pregnant, I never knew I was pregnant, I never knew I was pregnant”, she said repeatedly”.

It was a hard experience to deal with because according to her, she had always been cautious of her lifestyle to prevent any hindrance to childbirth, let alone experiencing an ectopic pregnancy something associated with cigarette smoking, sexually transmitted diseases, use of fertility drugs, and treatment, pelvic inflammatory diseases (PID) among others.

Soon after learning about the development through the indiscretion of the hospital’s sonographer during an ultrasound scan, and undergoing a series of tests prescribed subsequently, her doctors confirmed it.

Before she knew it, she was being rushed to the theatre for a procedure since she was in severe pain and bleeding profusely at the time.

She later discovered that one of her fallopian tubes was gone. The child she has been praying for, for the last five years never reached her womb.

‘My baby never reached my womb. The child I have been praying for all these years finally came but never reached my womb,” she said with teary eyes.

It has been three years already but Asiedua tells GhanaPlus.com she still lives with that dreadful experience.

“I am afraid to even think of getting pregnant. What if the next one too becomes an ectopic pregnancy? What if I lose my other fallopian tube?. What will become of my quest to become a mother then?” She said.

These and many more, Asiedua said, are the question still lingering on her mind.

Although she does not believe it could have been caused by spiritual forces within her family as often insinuated by society, the thought has crossed her mind, once or twice already.

Ectopic pregnancy

An Obstetrician and Gynecologist at the Mercy Women’s Catholic Hospital at Mankesim, Dr Felix Abeyifah Bowuo, said pregnancy is said to be ectopic when there is gestation or a baby outside its normal place, the uterus.

“Naturally the baby forms in the tube, the egg and the sperm meet in the fallopian tube so fertilization occurs in the fallopian tube, and then after the fertilization the embryo now moves into the uterus, and implantation and it grows, that is natural. That is how we are all formed.

 “After fertilization has happened if for one reason or the other this embryo is not able to move to the uterus, then it continues to stay in the tube and grows in the tube but the tube is not meant to carry a pregnancy, it can’t do that work, that is not its work because it is too thin,” he explained.

According to him, in about 95% of the cases, the fertilized egg implants in the fallopian tube, and this is known as a tubal pregnancy but can also occur in the abdomen, ovary, and even the cervix.

Ectopic is said to be life-threatening due to the risks of tubal rupture and hemorrhage and occurs most of the time within the first few weeks of pregnancy when most women are not aware they are expecting just like Asiedua’s case.

Dr Bowuo revealed, “ectopic is the leading cause of mothers dying during the early stages of pregnancy. During the early stages, most women who will die will die from ectopic and the rest is from abortion complications”.

BMC Pregnancy and Childbirth, open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth reports worldwide also noted ectopic pregnancy is one of the top leading causes of maternal mortality in the first trimesters of pregnancies and the leading cause of maternal morbidity and mortality worldwide.

The report added that the medical emergency condition account for some 10-15% of maternal death.

Symptoms

Symptoms includes light vaginal bleeding, pelvic and abdominal pain, upset stomach, vomiting etc.

In the case of ruptured ectopic pregnancy, the woman may experience sudden and severe abdominal cramps, pain on one side of the body, dizziness or weakness, pain on shoulder, neck or rectum and in some cases collapse.

Causes

Dr Bowuo who is a Member of the Society of Obstetricians and Gynecologists of Ghana(SOGOG) said up until now there are no known causes of ectopic pregnancy.

However, women with a previous history of ectopic, Pelvic Inflammatory Disease(PID), use of fertility drugs and treatment, smoking, surgery of any form in the pelvis and the fallopian tubes are at a higher risk with PID being the leading cause of the condition.

PID causes scars and adhesion in the fallopian tubes which block the free moment of the embryo to the womb.

Women above the age of 35years are also at risk.

Dr Abeyifah on Asiedua’s story

 Reacting to Asiedua’a story, Dr Bowuo said, she can boldly dissociate herself from the other risk factors but not for PID adding that it will be very difficult to tell as far as that is concerned.

“It will be difficult for her to tell whether she has not had any of them, especially the PID. Maybe she has some lower abdominal pain, some minor discharge, she goes to buy paracetamol, takes it, the pain goes. She wouldn’t go to the hospital to be told that you have PID. No!

 But the body tries to heal itself anytime, so even without medicine, it tries to heal itself so even though she wasn’t told she has PID, its possible that is the cause because it is the commonest cause of ectopic.

“It is possible that she had PID which was not treated well and she didn’t even know she had PID. So even, though she didn’t see herself having any risk factor, probably she had an infection that he didn’t know so she can’t say for sure that she never had any of those risk factors. No, is not true. For some, she can say for sure that she didn’t have it like pelvic surgery, the family planning method but the infection bit is difficult to tell,” Dr Abeyifah Bowuo emphasized.

Treatment

Speaking about Aseidua’s concerns, the renowned Gynecologist said although she stands a risk of experiencing the same, there is no cause to worry since there are interventions available to safeguard her remaining tube if it occurs.

All that is required of her is early knowledge of the pregnancy and a visit to a hospital soon after.

“Now she shouldn’t be afraid, she has another tube that she can get pregnant with. Am saying she shouldn’t be worried because when she gets pregnant and is in the tube and it is detected early, we can give her medications and injections to destroy the baby in the tube so one, she won’t go for surgery and two, that tube will still be there and she can get pregnant with it again,” the Doctor said.

“If it is not detected early and its ruptures, the tube will be destroyed as it happened to her the first time, that one we have no other choice then to remove it to save her life so for somebody who had had one tube removed, usually, we advised her that immediately you missed your period do a pregnancy test at home and come immediately”.

Even in the case of both tubes lost, Dr Bowuo said she still has the opportunity to get pregnant using In vitro fertilisation (IVF), a much more expensive option at a cost of some $7000 -$10, 000.

On the concern of spiritual influences, he said there is no such thing as far ectopic pregnancy is concerned.

Advice

Dr Bowuo advised women should not only be concerned about their pregnancies but also their location to help with the early detection of ectopic pregnancy.

“The catchword is this, any woman who misses her menses or suspects she is pregnant should do a home pregnancy test. If you can’t do it, go to the pharmacy they will do it for you. Is very cheap. That is the first step”.

“The next thing is to ask, where the pregnancy is? It is in the uterus or outside. One of the things that you can use is scan so immediately you know you are pregnant, the next thing is to go and do a scan. The scan will tell you whether the baby is in the uterus or not. If it is in the uterus then that is fine but if it is not in the uterus then the next step will be taken.

“Don’t say that as for me in my family, we don’t get ectopic, so for me, I will never get ectopic, it does work like that,” he cautioned.

He noted although sometimes the pregnancy might be too early to be detected by the scan, women must endeavor to honour their next appointment in order to get it done.

Dr Bowuo again urged women to prevent PID by avoiding multiple partners and also seek proper medical care whenever they experience it since untreated PID could increase chances of ectopic.

Source: GhanaPlus.com