in reply to a combox question

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more detail on tubal ectopic pregnancy treatment
scroll down, it's the second item on this page


I will have to disagree with some of the statements made in that post

THIS: "It is almost impossible for ectopic tubal pregnancy to happen without some preexisting disease or irregularity of the endosalpinx."

Low progesterone is a known factor that can decrease the motility of the cilia in the tube that help to transport the conceptus to the uterus. When the transport is too slow or fails, implantation can occur in the tube. It is fairly well known that "DES" daughters are also more prone to have tubal pregnancies, though I'm not sure why that is the case.

AND THIS: "different from salpingectomy is salpingostomy—where the tube is sliced longitudinally directly over the ectopic who is extracted with forceps or gentle suction with some appropriate instrument. The unborn is thus detached from the tubal wall and removed (death-dealing)."

Many practitioners do this precisely to try and save the baby, and try to move the baby into the uterus to see if it will attach. The other issue is that by slicing the tube, you can perhaps preserve it.

This author is arguing that removing the tube with the baby in it is different from removing the baby only, that the first is "ok", but the second is not. I say hogwash. He and the two people he is paraphrasing are using semantics. EITHER way, the baby dies. The question is, is the goal to literally save the mother, (ie is she in immediate, present danger?), or is the goal to prevent the pregnancy from continuing.

As he said, there are a fairly good number of tubal pregnancies that resolve on their own, (ie stop growing and/or start disolving).

That all said. I have to add that I had a chance to think all this through several years ago when I had a tubal pregnancy. No STD's ever, but a DES daughter and low progesterone...I agonized and was scared and asked God to take this decision out of my hands. My tube started bleeding, so we were left with no choice. By the time we got in the OR and the doctor opened me up (about 2-3hrs later), she found the pregnancy had "aborted" or moved into my uterus from the tube. She did try to save the tube but was not able to. Several weeks later, long after there should have been a heart-beat, there was still just an empty sac with no baby to be found, so we ended up having a D&C.

We were so hoping for a "miracle baby"...I felt so relieved though, knowing we had done all that we could and knowing we would not have to live with the "what if's" and the guilt if we had done something like accept the methotrexate or what initally would have been an "elective" surgery in my mind. God is indeed good.

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About this Entry

This page contains a single entry by alicia published on February 22, 2005 10:12 PM.

statements from authorities was the previous entry in this blog.

reflections on psalm 23 is the next entry in this blog.

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