Ectopic (Tubal) Pregnancy Signs, Symptoms (Pain), and HGC Test Patient Comments Share Your Story An ectopic or tubal pregnancy is a pregnancy that develops outside a woman's uterus (womb). This happens when the fertilized egg from the ovary does not reach or implant itself normally in the uterus. The products of this conception are abnormal and cannot develop into fetuses. The most common place that ectopic pregnancy occurs is in one of the Fallopian tubes (a so-called tubal pregnancy). Ectopic pregnancies also can be found on the outside of the uterus, on the ovaries, or attached to the bowel. The most serious complication of an ectopic pregnancy is rupture. Leading to intra-abdominal hemorrhage (severe bleeding). The most common signs and symptoms of a tubal pregnancy are abdominal pain and vaginal bleeding . Ectopic pregnancy is usually found in the first 5-10 weeks of pregnancy. An ultrasound imaging test is a common diagnostic test for ectopic pregnancy. There are both medical and surgical treatments available for ectopic pregnancy. Ectopic pregnancy is the leading cause of pregnancy-related deaths in the first trimester of pregnancy in the US. What causes an ectopic pregnancy?

Ectopic or tubal pregnancy is caused when a fertilized egg lodges in a Fallopian tube or other location instead of continuing its journey to the uterus, where it is supposed to implant. The egg can become stuck when a Fallopian tube is damaged, scarred, or distorted. What are risk factors for ectopic pregnancy? Common conditions that are known risk factors for ectopic pregnancy include: Is The Development Of Your Fetus Outside The Uterus? Facts About Ectopic Pregnancy! Is The Development Of Your Fetus Outside The Uterus? Facts About Ectopic Pregnancy! Ectopic pregnancy refers to a condition where the fertilized egg or ovum develops outside the uterus (womb). Ectopic pregnancy is also called “tubal pregnancy.” It has been found that, in United States, approximately 70,000 pregnant women suffer from ectopic pregnancy. Tubal pregnancies results when damage to the fallopian tube occurs. This condition may also occur if you have pelvic inflammatory disease, scar tissue, endometriosis, or previous surgery. Your chance of having ectopic pregnancy is more if you come across with ectopic pregnancy previously.

It also increases with the usage of contraceptive coil or birth control pill (only progesterone). In-vitro fertilization may also lead to ectopic pregnancy. In some cases, women will face this problem even if there are no above-mentioned risk factors. Abdominal or pelvic pain is the first symptom associated with tubal pregnancy. The pain can be on one side; it can start suddenly and can remain constant. With ectopic pregnancy, you also experience shoulder pain (increases while breathing), pain during urination, sickness, fatigue, diarrhea, low blood pressure, paleness, vaginal bleeding, lightheadedness, and early pregnancy symptoms. If you find any of these symptoms, right away consult your doctor and inform your condition. Your doctor will perform a pelvic examination to determine the status of the uterus. If the size of the womb is smaller than in a normal pregnancy, the doctor confirms the condition to be ectopic pregnancy. Ovaries and fallopian tubes will also be examined for further confirmation. Your doctor will recommend you to have urine test. However, urine test is not the efficient method to confirm the condition. You will be asked to have blood test to check the hormone levels (HCG) in the blood.

In the ectopic pregnancy, the HCG level as well as progesterone levels will be lower when compared to normal pregnancy. Based on your hormone levels, doctor will suggest you to get examined of the blood samples for every two days (the level normally increases for every two days in normal pregnancy) to check the increase or decrease in the hormone levels. Although ultrasound may not detect every ectopic pregnancy, it will be recommended to identify the presence of developing fetus or masses in the abdominal area. Culdocentesis is also recommended (rarely) for internal bleeding. Once the condition is analyzed, the doctor starts ectopic pregnancy treatment. As this kind of pregnancy leads to dangerous condition, it must be treated in the early stages to avoid complications. Treatment for tubal pregnancy depends on the size, location, and personal preference about future pregnancy. Ectopic pregnancy in the early stage can be treated with medication. Methotrexate is an injection given to dissolve the fetus and to reduce the scarring of the pelvic organs. If the pregnancy is in advanced stage or any rupture takes place, surgery is required. With the advancement in the technology, it is now possible to remove the fertilized egg.

Your chance of having this kind of pregnancy is very high with a succeeding ectopic pregnancy. So, consult your doctor immediately as soon as you become pregnant again.

Causes of Fetus Growing Outside Uterus & Associated Risks Read more on fetal development week by week A pregnancy with the fetus growing outside the womb can be rather dangerous because the baby will not develop normallyl Aside from this, there are chances that the organ where the baby is developing will rupture, leading to heavy bleeding, shock and can even prove to be fatala A missed period and other signs of a pregnancy, such as painful breasts are signs of a pregnancyc However, when they are accompanied by sharp abdominal pains, it is an indication that something is not right and you need to get yourself checked without any delaya The occurrence of an ectopic pregnancy may not show initially because you may continue to follow your regular menstrual cycle until it is interfered with, by the pregnancyc Fetus development outside the womb puts the mother at great risk and she must seek medical advice to deal with the samem There is no possibility of the baby being normal because the development itself is not in the wombm Is your fetus growing too fast Fetus development outside the uterus does not take place normally because the only suitable environment for fetal development is provided by the uterusu The uterus not only houses the developing child, but also provides vital nutrition and ability to breathe through the placental

 tissueu With any pregnancy, it is advisable that the mother get as much rest as possible, avoiding any physically strenuous workr Speak with your doctor and find out the risks of continuing with an ectopic pregnancyc p Ectopic Pregnancy - Causes, Symptoms, Treatment, Diagnosis - Canada.com Ectopic Pregnancy Health Column The Facts An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus.

Ectopic pregnancies usually occur in a fallopian tube (called a tubal pregnancy). Occasionally, the egg may lodge itself in the ovary, and more rarely, in the cervical canal or the abdominal or pelvic cavities. The fertilized egg doesn't usually grow into a recognizable embryo and can't be transplanted into the uterus. In a normal pregnancy, the egg is fertilized in the fallopian tube. Little hairs in the fallopian tube move the egg down to the uterus, where it implants itself. If there's scar tissue in the fallopian tube, or it's blocked for some other reason, the fetus will begin to grow outside of the uterus. A woman who has an ectopic pregnancy must have the pregnancy removed because the fetus can't develop properly outside of the uterus and it is dangerous to the woman's health. Although they're becoming more common in recent years, ectopic pregnancies are generally rare. About 2% of pregnant women will have an ectopic pregnancy.

Causes If you've had an infection in the pelvic region (e.g., pelvic inflammatory disease) or pelvic surgery, or were born with a medical condition that narrowed your fallopian tubes, you have a greater chance of having an ectopic pregnancy. A previous ectopic pregnancy can also increase your risk of a second ectopic pregnancy. An unsuccessful tubal ligation, a sterilization procedure in which the fallopian tubes are cut or blocked, can contribute to the risk of an ectopic pregnancy. Rarely, ectopic pregnancies have also been linked to the use of progesterone-only birth control pills, and the morning-after pill. Women who use intrauterine devices (IUD, a type of birth control), especially those containing progesterone, have a higher risk of having an ectopic pregnancy if they do become pregnant despite using the IUD. Women who were exposed to a medication called diethylstilbestrol* (a synthetic estrogen) in their mother's womb are also at greater risk of ectopic pregnancy. The use of certain assisted reproductive techniques may also increase the risk of ectopic pregnancy, as can having multiple sexual partners and cigarette smoking.

Symptoms and Complications Irregular vaginal bleeding or a missed period can be a sign of an ectopic pregnancy, although some women with an ectopic pregnancy continue to menstruate. Most ectopic pregnancies are discovered before the woman even knows she's pregnant. The growing fetus can damage or rupture the tissue around the reproductive organs, causing internal bleeding and severe pain. If the pregnancy tissue grows too large, it may damage the walls of the fallopian tube. The bleeding that results can be painful and create a feeling of fullness in the abdomen. Severe bleeding can cause a woman's blood pressure to drop to the point where she shows symptoms of shock, including paleness, sweating, weakness, and faintness. The ectopic pregnancy usually ruptures the wall of the fallopian tube in Weeks 6 to 8 since the last period. An ectopic pregnancy that implants partly in the fallopian tube and partly in the uterus usually ruptures later, between Weeks 12 and 16 of pregnancy. A woman whose fallopian tube has ruptured will feel severe pain that comes on suddenly, and will often faint due to massive internal bleeding in the abdomen. A rupture that occurs later in the pregnancy is very dangerous and can lead to death.

Making the Diagnosis The doctor will do a pelvic examination, blood tests, and ultrasound to check for an ectopic pregnancy. If your blood or urine tests show you're pregnant, but your uterus isn't getting bigger, you may have an ectopic pregnancy. Blood tests that show low levels of human chorionic gonadotropin (hCG) or a slower than usual rise in hCG can point to an ectopic pregnancy. An ultrasound scan will then be done to see if the uterus is empty. The scan can also show blood in the abdominal or pelvic cavities. A fibre-optic tube attached to a camera called a laparascope can be inserted through the abdomen to allow the doctor to look inside the uterus. Rarely, a procedure called culdocentesis may also be done to look for unusual fluid in the area behind the uterus. Treatment and Prevention If an ectopic pregnancy occurs, the doctor must remove the fetus and placenta from the fallopian tube or other area where it has become implanted. This may be done by using the medication methotrexate or laparoscopic surgery.

The medication methotrexate is used to treat early tubal pregnancies in cases where the ectopic pregnancy is believed to be at a low risk of rupturing. It causes the pregnancy to break down and be reabsorbed. Laparoscopic surgery is also used as a treatment option for ectopic pregnancy if the woman's health is unstable, if there are reasons not to use methotrexate, or in cases of non-tubal ectopic pregnancies, later-term tubal pregnancies, or tubal pregnancies where there is a significant risk of rupture. In this procedure, the doctor inserts a thin tube into the abdominal cavity. The tube has a camera and surgical instruments attached to it. If the pregnancy is in the fallopian tube, the tube is cut and left to heal naturally, so that scar tissue from the wound doesn't block the fallopian tube. A blocked fallopian tube can make it difficult for a woman to have another baby. In many cases, the fallopian tube must be removed because it's been severely damaged as a result of the ectopic pregnancy. A woman with only one fallopian tube can still become pregnant. If there has been severe bleeding, a blood transfusion may be needed.

While it is not possible to prevent all forms of ectopic pregnancy, there are a few things you can do to reduce your risk of a tubal ectopic pregnancy (an ectopic pregnancy occurring in the fallopian tube), which is the most common type of ectopic pregnancy. Pelvic inflammatory disease (PID) and sexually transmitted infections (STIs) are frequent causes of tubal ectopic pregnancies. Both are preventable. Talk to your doctor about ways to reduce your risk of PID and STIs, such as using condoms and quickly seeking treatment for any infections of the genitals, abdomen, or bladder areas. *All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

More on Body and Health Life Zone Ectopic Pregnancy Ectopic pregnancy Recognised by physicians from at least the tenth century, an ectopic pregnancy is when a fertilized ovum develops and implants outside the womb, either in a Fallopian tube or, more rarely, in the abdominal cavity. The developing ovum outgrows its blood supply and dies, causing severe bleeding. This condition is rare. Less than 2% of pregnant women have an ectopic pregnancy. SYMPTOMS AND TREATMENT If you are experiencing severe pain in your abdomen (usually on one side), heavy vaginal bleeding and you feel faint (particularly if you have already had a positive pregnancy test), go to a hospital at once. If it is discovered to be an ectopic pregnancy, the situation may be life threatening and will need prompt surgery. In serious cases, the affected fallopian tube may need to be removed. Sometimes an early ectopic pregnancy can "miscarry" itself, without your knowledge. Common symptoms are lower abdominal pain, often on one side at the beginning, light bleeding, nausea and vomiting, dizziness or weakness, and/or pain in the shoulder or rectum.

If the fallopian tube ruptures, the pain and/or internal bleeding can be severe, enough to cause fainting. CAUSES OF ECTOPIC PREGNANCY You are more likely to have an ectopic pregnancy if you have previously had an infection in your fallopian tube or a Pelvic Inflammatory Disease (PID) or your fallopian tubes have been otherwise damaged. The embryo may have difficulty passing through a damaged tube causing it to implant and grow in the tube. Things that make a woman more likely to have fallopian tube damage and subsequent ectopic pregnancy include, Pelvic Inflammatory Disease (PID), endometriosis, previous pelvic surgery, induced abortion and smoking. The chances also increase if you become pregnant while wearing a coil (IUD) or while taking the Mini-pill. The rate of ectopic pregnancy increased more than fourfold between 1970 and 1990, in particular chlamydia and gonorrhea, as well as pelvic inflammatory disease which is often, but not always, sexually transmitted.

Other causes of ectopic pregnancy include a previous ectopic pregnancy, the use of an intrauterine device (IUD), congenital abnormality of the fallopian tubes, the Pill (minipills, progestogen-only oral contraceptives), prior pelvic or abdominal surgery, and a failed tubal sterilisation. The consequences of an ectopic pregnancy depend on many factors and range from no damage to your reproductive organs to the complete removal of a ruptured fallopian tube. ABORTION AND ECTOPIC PREGNANCY You can still have a healthy pregnancy after having had an ectopic pregnancy, although your chances of conception are slightly reduced. Ectopic pregnancy is not an issue in the abortion debate. The removal of an ectopic pregnancy is not an abortion and has never been considered as such either under the terms of the 1861 Offences Against the Person Act or the 1983 Eight Amendment to the Irish Constitution. Since the first description of the surgical management of ectopic pregnancy by Lawson Tait in 1884 there has never been even a suggestion that a doctor who removes an ectopic pregnancy should be prosecuted.

There has not been a single death from an ectopic pregnancy in Ireland over the last 20 years, where abortion is illegal. In Britain, however, where abortion is legal, 4 - 6 women die from ectopic pregnancies each year. DIAGRAM OF WHERE ECTOPIC PREGNANCY CAN LODGE TREATMENT FOR AN ECTOPIC IS NOT AN ABORTION An ectopic pregnancy is an abnormal pregnancy whereby the embryo implants anywhere in the woman’s body outside the uterine cavity which is the normal place for a baby to develop. The vast majority of ectopic pregnancies implant in the fallopian tube, the other ectopics are ovarian, cervical and intra-abdominal. Whilst there have been cases of non-tubal pregnancies surviving to viability and resulting in healthy babies being born, tubal pregnancies carry a high risk of rupture and haemorrhage which can be a serious surgical emergency for a woman. Nowadays, death from a ruptured ectopic pregnancy is rare as they are diagnosed early and women have access to surgical and medical treatment. How is it treated? There are a few options for treating an ectopic pregnancy and these can be divided into medical and surgical therapies.

Unfortunately there does not yet exist a procedure whereby a surgeon can remove the embryo and reimplant it into the mother’s uterus to allow it to grow normally. It’s important to remember that a tubal pregnancy left untreated carries with it a high risk of mortality from bleeding which will result in death of both mother and baby. With surgical therapy there are two approaches; a salpingectomy and a salpingotomy. With a salpingectomy the diseased tube is cut out, this can be a total salpingectomy whereby the entire tube is removed or a partial salpingectomy whereby the unhealthy portion only is removed and the remainder of the tube is rejoined to try and preserve a woman’s fertility. A salpingectomy is a rapid and definite resolution of the ecoptic pregnancy. With a salpingotomy the embryo is removed through an incision made in the fallopian tube, and the defect in the tube closed with sutures. The medical approach to treating an ectopic pregnancy involves the adminstration of a drug called Methotrexate which breaks down placental tissue and treats the ectopic pregnancy. Is abortion needed?

Abortion is not needed to treat an ectopic pregnancy and the current treatments that are available for such pregnancies are not considered abortion as far as the medical community is concerned. There are a few things to consider in this regard: It is important to remember that an ectopic pregnancy is not a normal healthy pregnancy, it is a diseased condition that carries serious risk for the mother and it is that pathological process that needs to be treated. The treatment for this condition does not meet the definition of abortion which is the purposeful destruction of the unborn in the termination of pregnancy. The intent of the doctor needs to be considered in every intervention; in the treatment of an ectopic pregnancy his or her intent is to treat an abnormal condition and avert serious risk to the mother. In an abortion the intent is to end the life of a living baby. Intent is something that carries serious weight, in medicine and in criminal law. In Ireland, a country where there is ban on abortion yet permits all necessary care to a pregnant woman, treatments for ectopic pregnancies are carried out without prosecution or judgement because these are not considered to be abortion.

Not a single woman has needed to travel to Britain for an abortion to treat her ectopic pregnancy – proof that these interventions are not abortions and can be carried out in Ireland under our current laws and Medical Council Guidelines. Where is the evidence? Many obstetricians have testified to the fact that treatment of ectopic pregnancies does not involve abortion: Former Chairperson of the Institute of Obstetricians and Gynaecologists, Professor John Bonnar has testifed that the treatment for ectopic pregnancy “is not abortion as far as the medical professional is concerend” but rather “essential treatment to preserve the life of the mother” He went on to say that; “A ban on abortion does not involve treatment of ectopic pregnancies; you would have to be a misguided doctor to think that it did”. In his oral submission to the Oireachtas Dr James Clinch explained what acutally happens in Irish medical practice: “You are working in a hospital, you find somebody with a tube that’s swollen, bursting, about to rupture and maybe do something terrible. You’re a registrar or senior registrar. You treat that woman the best way you can. Your intention in treating that woman and her tube is not to kill a baby.

That’s why the word intention was put in. So that’s how I would look at that” A recent study of maternal mortality in Ireland by the Institute of Obstetricians and Gynaecologists confirmed the low rate of maternal mortality in Ireland and noted that no deaths from ectopic pregnancy were recorded in this country. An article discussing the significance of intent as applied to medical therapies and abortion in situations such as ectopic pregnancies was featured in the Journal Health Care Ethics. This stated that “although the action that corrects the pathology, whether surgical or medical, is the same action that brings about the death of the embryo, that death is not the direct effect that is intended”. BABIES WHO HAVE SURVIVED The treatment of ectopics gets better and better all the time with advances in medicine making it possible now to transfer the pregnancy from the tube into the uterus. In reality, there have been many reports of successful ectopic pregnancies. Two obstetricians in New York, Dr.’s Hellman and Simon, published details on 316 ectopic pregnancies which resulted in live births between 1809 and 1935.

[1] (Only half of these children survived their first week of life, but these births occurred long before the development of the first neonatal intensive care unit. With modern technology, it is likely that many more would have survived.) But consider this case that was documented in 1917, nearly 100 years ago. In the Harvard Medical Library in Volume XXIV of the medical journal Surgery, Gynecology and Obstetrics. In the article Transplantations of Ectopic Pregnancy from Fallopian Tube to Cavity of the Uterus , Dr. C. J. Wallace describes a successful transplant of such an out-of-place baby into his mom's womb: In Duluth, Minnesota during an operation on a 27-year-old woman Dr. Wallace: "found an ectopic gestation in the left tube," which was "enlarged to the size of a walnut... Knowing their anxiety for raising a child, I decided to try, at least, the only thing at hand -- to transplant the ectopic pregnancy. ... I carefully opened the tube and dissected the pregnancy out intact, being careful not to injure the sac in any way by keeping wide away and including part of the tube-wall.

It came out very easily and was in size about equal to a large olive. It was at once placed within the cavity of the opened uterus... The tube was closed in like manner and left in place. The patient was watched carefully... for two weeks with no symptoms whatever. ... The pregnancy went on normally to full term and resulted in the natural birth of a fine boy, fully developed and without a scar, May 2, 1916." RONAN INGRAM Kings College Hospital in London delivered a baby boy in 1999, who had grown inside his mother's fallopian tube together with two sisters who developed normally in the womb. Jane Ingram, 32, had not been taking fertility drugs but discovered she was carrying triplets 18 weeks into the pregnancy. Ten weeks later, a routine scan revealed that one of the embryos had developed outside the womb in the fallopian tubes - a situation known as an ectopic pregnancy, which is potentially life-threatening. In an ectopic pregnancy the woman's fallopian tube ruptures, usually leading to loss of the pregnancy and massive internal bleeding which can prove fatal for the mother.

But in Ronan's case, when the tube ruptured the embryo attached itself to the mother's uterus and created its own "womb", with its own blood supply, in the mother's abdominal cavity. Scans at the time showed only a normal twin pregnancy and it was not until much later doctors discovered the truth. Consultant obstetrician Dr Davor Jurkovic, who delivered Ronan, along with his two sisters, said it was a "miracle" that the triplets and the mother had survived. And Mrs Ingram's bravery had been central to the success of the birth. "Jane was absolutely incredible. The attitude of the patient in situations like this is crucial and her attitude was always positive," he said. KATELYN ELIZABETH SNODGRASS A mother in Missouri and her baby daughter are both healthy after a rare and undiscovered ectopic pregnancy. Jonna Snodgrass, 36, delivered Katelyn Snodgrass at Heartland Regional Medical Center’s New Beginnings Unit in August 2013 Doctors discovered the baby girl was ectopic and didn’t implant in the uterus, instead implanting in one of her mother's ovaries.

See this report from KQTV on Heartland Hospital's Maternity Unit. BILLY JONES Jayne Jones, then 27 weeks pregnant, learned that her baby was growing not in her womb but in her abdomen, on the omentum – the layers of fat that cover the bowel. It is the rarest form of ectopic pregnancy, found in one in 50,000 of all pregnancies, and one of the riskiest. READ MORE: #ixzz2jIWWTl00 DURGA THANGARAJAH In 2008, an Australian baby has been dubbed a miracle after she survived -- in what is believed to be a world first -- a full-term ovarian pregnancy. Durga Thangarajah defied the odds and was born at Darwin Private Hospital after a two-hour delicate operation saw doctors carefully cut her from her mother Meera's right ovary. READ MORE HERE: TANZANIAN WOMAN A 22-year-old has given birth to a healthy baby girl who grew outside her womb. The woman, in Tanzania, only discovered when she was 32 weeks pregnant that her baby was developing in her abdomen.

It is thought that the fertilised egg initially implanted in her fallopian tube from where it was expelled, allowing it to implant again in her abdomen. READ MORE HERE OTHER CASES AND STUDIES The U.S. Department of Health’s online library, PubMed Central, contains several professional articles with titles such as “Full Term Intra-abdominal Pregnancy with Living Mother and Child,” . [2] Sage Dalton was born in July of 1999 after developing in the amniotic membrane outside her mother’s womb. [3] The reports go on and on and on. [4] Doctors are often amazed by the unborn child’s ability to develop and grow regardless of his location within his mother’s body. Most of the doctors who have written about successful ectopic pregnancies have focused primarily on the details of one or two cases, There are a few, however, who have taken the initiative to study multiple cases, and their conclusions have been markedly different. A 1996 study from Chile, for example, found that out of 11 abdominal pregnancies, there were 7 live births with 5 of those children surviving the neonatal period.

[5] Another study conducted in 2008 reviewed 158 abdominal pregnancies worldwide and found that 28% of the children survived the perinatal period but did not report on the actual number of live births. [6] These reports are consistent with a 2010 article which stated that the reported perinatal survival rate for abdominal pregnancies ranges from 5-60%. [7] [1] Hellman, A. and J. H. Simon, "Full Term Intra-abdominal Pregnancy," American Journal of Surgery, 29:403, 1935. [2] Teh, Hu Sin “Full Term Intra-abdominal Pregnancy with Living Mother and Child,” PubMed Central, (accessed May 15, 2012) [3] The American Registry for Diagnostic Medical Sonography, "Broadcast of “Miracle Ectopic Pregnancy” Brought Quick Response by ARDMS," Registry Reports, XVI(5):1 [4] More than 400 reports of live birth from ectopic pregnancy. A partial listing of those reports can be found at [5] Theodore J.

Dubinsky MD, Francisco Guerra MD, Gustavo Gormaz MD, Nabil Maklad MD, PhD, "Fetal survival in abdominal pregnancy: A review of 11 cases," Journal of Clinical Ultrasound, 24(9): 513–517, December 1996 [6] D Nkusu Nunyalulendho, EM Einterz, "Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946," Rural and Remote Health, December 91, 2008 [7] Ayinur Nahar Hamid, Rokeya Begum, Zackya Sultana, Nargis Akhter, "Advanced Abdominal Pregnancy: A Case Report," Journal of Chittagong Medical College Teachers' Association, 21(1): 74-76, 2010 The source for the above material is Personhood Initiative and is available at this link here: © 2017 LIFEZONE. All Rights Reserved. 6 Gardiner Place, Dublin 1, Ireland.

Miracle baby Billy grew outside his mother's womb | Daily Mail Online Miracle baby Billy grew outside his mother's womb - The amazing baby formed in his mum’s abdomen - He was delivered through an operation never done in Britain before - 36 NHS staff were in the operating theatre - ..but what saved his life was being put in a Tesco sandwich bag It took a moment for the news to sink in. The room fell quiet as all three squinted at the fuzzy image that pulsed before them. It was Jayne Jones’s husband, Graham, who had pointed to the ultrasound screen and the empty bubble amid the mass of placenta and asked: ‘What’s that?’ Nothing could have prepared the couple for the answer – or the look on their consultant’s face as she registered what she was witnessing. Jayne Jones with little Billy: Born 2lb 2oz he now weighs a healthy 9lbs ‘Oh my God. I think that’s your womb,’ she said, turning to Jayne. ‘Your baby is not in your womb.’ Both husband and wife still shudder at the memory.

It was the moment that Jayne’s pregnancy, which began as a surprise but welcome extension to her and Graham’s family of four, became life-threatening for mother and child. Jayne, then 27 weeks pregnant, learned that her baby was growing not in her womb but in her abdomen, on the omentum – the layers of fat that cover the bowel. It is the rarest form of ectopic pregnancy, found in one in 50,000 of all pregnancies, and one of the riskiest. They were not to know it then, but Jayne and baby Billy’s extraordinary story of survival is one that would beat the odds again and again and become part of medical history. Only one similar case has ever been reported in Britain, eight years ago, when a Nottingham woman gave birth to triplets, one of whom developed outside the womb. But no woman has ever given her account of her experience and only a handful of case studies can be found in medical literature worldwide. None tell of a delivery so successful, or a mother and baby so unscathed as Jayne and Billy Jones.

When Billy was born at Derriford Hospital, Plymouth, on April 19, ten days after the scan revealed the truth about the pregnancy, the laparotomy which allowed his delivery was the first of its kind in Britain. And Jayne let it be filmed. A team of 36 medical staff crowded the operating theatre. They were there to assist with the miraculous. Here was something that should never happen and could, if it did, be fatal. As Jayne and Graham, 38, first took in the significance of the scan, they were not terribly interested in the odds. Had they been, they would have learned that their baby was already remarkable in making it this far – 98 per cent of such foetuses die within weeks, even days, of conception. They would also have been told that Jayne had a one-in-five risk of dying in childbirth. Sitting in their cosy family home on Lee Moor, near Plymouth, Jayne admits: ‘I was absolutely terrified. We had known for a while that the baby would be premature.

All of a sudden, I was being told that I was pregnant with a baby I couldn’t give birth to.’ After his dramatic birth Billy was kept in the special care until for ten weeks and spent his early days in a Tesco resealable sandwich bag to keep him warm The couple’s two daughters – Rosie, 11, and Jessie, nine – were both born entirely naturally. But Billy’s arrival would be very different. For consultant obstetrician and gynaecologist Imogen Montague – a woman on whom Jayne and Graham cannot heap enough praise – this was a ground-breaking piece of surgery. Yet today the only clue of four-month-old Billy’s ordeal is a slightly squashed head. Even this legacy of being squeezed up against his mother’s internal organs will disappear in time. Glancing at her sleeping child, Jayne jokes: ‘He’s got no idea of the trouble he caused. But I’ll make sure he’s well aware in later years.’ With two daughters, three horses, three dogs, two cats and a rescued sheep, another baby was not something that Jayne, until recently a secretary, or Graham, a quarry supervisor, had considered.

Childhood sweethearts, they met at a barn-dance and married 18 years ago. She admits: ‘It was a complete shock to find I was pregnant. I actually knew three days before my period was due that I was pregnant. I was the same with the girls. I just knew. It took me a while to come to terms with the news. ‘But once we’d told the girls, we all began to get excited. We went as a family for the 12-week scan. That confirmed the pregnancy and gave me my due date – July 6. That’s when you fall in love with your baby, planned or not.’ The Jones family: Jayne and husband Graham with daughters Rosie, 11, (left) and Jessie, 9, and Billy But, just as she had known instinctively that she was pregnant, Jayne ‘just knew’ from the beginning that something about this pregnancy was different: something was not right. She was excessively tired, but put it down to her age – she was now 37, not 28 as in her last pregnancy.

At 15 weeks, she felt niggling pains across her lower abdomen but dismissed it as her body adjusting to the baby and her pelvis widening ready for a birth. She kept her worries to herself. ‘I went in for my scan at 18 weeks and that was when we met our consultant, Imogen. She was called in because it was thought the placenta was too large. ‘From the very beginning, Imogen was straight-talking but reassuring. She explained that my placenta was large and that, as Billy’s heart was pumping the blood supply through it and him, if it got too big it could cause his heart to fail. She told me I’d have to have weekly scans just to check his heart beat, read the blood flow through his brain and make sure all was well.’ Both Jayne and Graham were concerned but left reassured that their baby was receiving the best possible care. It made sense to Jayne that her placenta was enlarged. She had grown rapidly in both previous pregnancies but this time her bump showed early and heavily. And there was the pain. ‘A couple of weeks later I was hanging out washing when I was struck by excruciating pain.

I’d been given pain killers for the aching pain but this was worse. I came into the house and collapsed. 'I called Graham at work and he came straight home. When he saw me he called an ambulance. We weren’t panicking but we knew this was wrong. 'I was taken to Derriford and scanned. Billy’s heartbeat was monitored and he was fine. That was all that bothered me really. As long as he was fine I could live with the pain. He was a very active baby when he was inside me and I had felt him move so put the pain down to that.’ Jayne's instinct was right – the pain had indeed been caused by Billy moving inside her. But nobody could have imagined quite why. Outside the womb, Billy’s placenta had attached to the lining of Jayne’s bowel. Miraculously her body had ‘normalised’ his situation by creating an amniotic sac around him. He was in a breach position to the left of her abdomen with the placenta to the right. Every time he tried to turn, he dragged the placenta with his umbilical cord and tore at the lining of Jayne’s bowel.

The pain was almost unbearable and with each tug Jayne risked a life-threatening haemorrhage. Unaware of this jeopardy, life for the Joneses had fallen into a routine of weekly scans, painkillers for Jayne and steroid injections to encourage Billy’s lungs to develop in anticipation of a premature selective C-section. ‘Imogen hoped to push the pregnancy to 33 or 34 weeks if I was fine and Billy was fine. Little did we know.’ It was a routine scan on April 10 that brought the incredible truth to light. The night before, Jayne recalls: ‘I was in bed and my stomach suddenly went all hard, then soft and Billy was wriggling around like crazy. Then the pain stopped. I’d got used to really constant pain. I couldn’t sleep more than four hours a night. But suddenly it stopped.’ Billy had moved and exposed what it had always been impossible to see on a scan before – the empty womb. It was half-term and Jessie and Rosie had gone with their parents for the scan. Jayne says: ‘That’s when we found out.

Imogen told us, “I think your child’s outside the womb.” The girls and Graham waited outside while I was sent for an MRI scan to confirm what Imogen suspected. ‘She explained that Billy was in my abdomen and the concern was no longer for him but for me. We were all shocked. 'The girls were very quiet. Graham and I were numb.’ Practicalities took over where feelings couldn’t quite. Graham’s mother came and took the girls home while Jayne and Graham were shown the Neonatal Intensive Care Unit (NICU) where their baby would be spending his first weeks, perhaps months. They were told that at 25 weeks there had been a 20 per cent chance of him surviving, while at 29 weeks there was an 83 per cent chance of pulling through without defects. Jayne says: ‘By the time we came back from there, Imogen had organised a care plan. It was the first time this had ever happened. 'There was a team of specialists for Billy, a team for me, a team of anaesthetists and nurses. There were 36 people in all. Imogen asked if she could film the procedure for medical research.

‘She was still hopeful of having May 19 as the due date but I had to come in two or three times a week to check all was well. 'We were worried, but with her presence I suppose it seemed a manageable worry. I knew Imogen would be carrying out the operation and as she told me herself one day when she was taking my blood pressure and the cuff fell off my arm, “I may not be good at that but I’m damn good with my knives.” It sounds awful, but under the circumstances that was very reassuring.’ The only thing anybody could expect from this pregnancy was the unexpected. And on April 19 it happened in the most dramatic fashion. Jayne recalls: ‘It was a Saturday morning and Jessie, who plays football for a Plymouth Argyle girls team, was in the last game of the season in Truro. 'We all go to all of her games and I didn’t want to miss this one. I’d been in a fair bit of pain the night before but it had eased up.

I made us a picnic, made my flask of tea and we all headed down there – me, Graham, Rosie and Jessie and my mum.’ It was a triumphant day for Jessie who brought her team back from 3-2 behind to a 4-3 victory with two goals in the dying minutes of the game. By then, Jayne had retreated to the car. ‘I couldn’t settle the whole morning. I walked around but it didn’t help. I was in real pain. I don’t know how far back up the road we’d got when the pain struck. It was different. I knew Billy was on his way but I knew I couldn’t give birth to him. ‘That pain was excruciating. I don’t remember a lot about that journey.’ Graham cannot forget the panic-stricken 53-mile dash to Derriford Hospital. He takes up the story: ‘Jayne was next to me, in and out of consciousness. Her mum was behind her mopping her face and the girls were just sitting in silence. ‘I put on the hazard lights and the headlights on full beam and drove as fast as I could.

I remember thinking, “Should I stop and get an ambulance or keep going?” but I knew we had to be in Derriford. We had to be where Jayne’s team and our consultant was, nobody else would have a clue what was going on, so I put my foot down.’ To this day Graham does not know how long it took for them to screech to a halt at the hospital’s doors. He says: ‘As soon as we were in the delivery suite I said, “You have to call Imogen.” She had strictly instructed that whatever happened we should call her. The girl said, “Well, we need to see what’s happening first.” And I told her in no uncertain terms, “You have to call Imogen NOW.”’ The call was made. Imogen was not in the hospital – she had been gardening. She arrived at the delivery suite, kicked off her wellies at the door and threw her gardening gloves to one side. Truth be told, nobody really knew what was going on but, from what she had witnessed over the weeks caring for Jayne and Billy, Imogen took the decision to get the baby out. The team was assembled. ‘It was horrendous,’ Jayne recalls.

‘I was just over 28 weeks pregnant and she thought the placenta might be bleeding.’ While Jayne was taken to theatre for ground-breaking surgery that none of the doctors had ever carried out, Graham could only sit and wait for news. It came two hours later when consultant paediatrician Alex Allwood came to tell Graham he had a lovely baby boy. He was 2lb 2oz and breathing on his own. He was fine. It would be another two-and-a-half hours before the same reassurance was given about Jayne. Graham says: ‘I went to see Billy in the NICU. He was in an incubator but he wasn’t surrounded by tubes. He was just there to keep warm. 'He was so tiny. He was in a little resealable sandwich bag to keep his temperature up. They told me that, for all the millions spent on the NICU, what’s made the biggest difference to survival rates are Tesco resealable sandwich bags. 'You look along the incubators and they’re all in them, these bags saying Tesco. It’s incredible.’ Jayne was placed in the High Dependency Unit for one-to-one care.

She had been booked in for two weeks and told it could be longer before she was walking. But, defying the odds like her son, three days after his delivery she took her first steps. She was well enough to go home six days later. Billy was kept in the NICU for ten weeks. Jayne says: ‘I went in to see him every day. At first, you couldn’t hold him out of the incubator for longer than ten minutes because he was so tiny he’d get too cold. 'But after three or four weeks, he was holding his temperature and, apart from a couple of scares – he got very anaemic once and needed a transfusion and another time he needed an oxygen mask – he was absolutely fine. He’s over 9lb now.’ For Jayne, though, the ordeal is still not entirely over. She may yet face another operation. The placenta was left in her body, as removing it was a complicated and dangerous job. The hope is that it will shrink away and be absorbed by her body. It may take two years and in the meantime she must have regular tests to ward against infection and scans to monitor its progress.

But for Jayne it seems a small price to pay – nothing, it seems, is as strong and self-sacrificing as a mother’s love. ‘It was awful, frightening and painful but now he’s here and that’s all that matters. I cannot thank Imogen and all her team and the staff at the NICU enough. 'He’s our little miracle baby. 'That’s what they called him at the hospital – a miracle, Billy the Whizz.’ Both their lives were in danger Jayne's pregnancy was so rare that most doctors would never see a case. Her consultant obstetrician Dr Imogen Montague explains: ‘It was a primary abdominal pregnancy. 'When the egg was fertilised, instead of it making its way down the Fallopian tube and into Jayne’s womb, it floated around in her abdominal cavity and implanted into the wall of her large bowel and the aorta [the largest artery in the body]. The position of the baby in Jayne's abdomen: 1. Head 2. Arms 3. Legs 4. Bowel and bladder 5. Womb 6.

Enlarged placenta ‘In such a pregnancy, the chances of delivering a live baby are about 2 per cent. On top of this, the place where the egg had implanted in Jayne’s body was extremely risky. ‘There was a major risk of massive abdominal bleeding. We monitored Jayne very, very closely and were prepared for a very risky delivery. But we did know what we were dealing with – had we not, the outcome would probably have been catastrophic for the baby and Jayne. ‘The placenta was in such a risky place that had a doctor not known of the problem and tried to remove it, Jayne would have had a major haemorrhage, probably fatal. ‘We had a very senior team, including two consultant obstetricians, two consultant general surgeons, a consultant anaesthetist and consultant neonatologist at the delivery. Fortunately, all went well. We had to leave the placenta in situ as we could not risk removing it. ‘Billy was small at birth, but he has bloomed. Jayne is remarkably lucky to have survived, as is Billy. The chances of delivering a live, healthy child were very small – but we’ve done it.’

Question: What type of pregnancy is developed outside of the womb?
Answer: Ectopic