A young wife came to our clinic. Her family is one of the most important families in Egypt. She came to us suffering from severe pelvic pain
She had just delivered her baby 3 months ago. And unfortunately, she was diagnosed with ectopic pregnancy two months after (Ectopic pregnancy refers to attachment of the forming embryo outside the womb). What made it even worse is the exact location of her ectopic pregnancy. The most common location of this condition is the fallopian tube, but in her case, the embryo has attached to the incision site of her previous cesarean delivery
Her laboratory work up revealed pregnancy test level of 51.000. This high level of the hormone indicates that the pregnancy state is still going. Her ultrasound scan detected a clear gestational sac, adjacent to the urinary bladder and very near to cervix with intact strong fetal pulsation . Her gynecologist suggested medical treatment to stop the fetus heartbeat. Her other choice was surgical intervention to remove the whole products of conception with part of womb and the possibility of bleeding is high . She chose the medical treatment
She came to us in a critical condition. After initial examination, we detected a strong heartbeat, growing gestational sac, weakness of cesarean incision and enlarged womb. That meant failure of medical treatment with her
Our reply to her case was just one word “Laparoscopy”. Sometimes you have to be decisive and clear. With god’s help, we were able to remove all the ectopic tissue, with preservation of the whole womb . The bladder wasn’t affected, and the previous cesarean incision was repaired. All was done during the same laparoscopic intervention
“If you want to go out and have dinner with your friends the next day, you can” she was told.She left the hospital the next morning
Key points
Medical professionals can have different opinions
Recently, laparoscopy has become the main surgical intervention for many medical conditions
Ectopic pregnancy, with strong fetal pulse, and B.HCG hormone level more than 50.000, has to be dealt with by laparoscopy
Cesarean delivery can cause some weakness in the womb wall at the site of incision. Decreased fertility and ectopic pregnancy are possible complications for it
After any delivery, discuss the options for birth control with your treating physician
