Ectopic pregnancy – A Life Threatening Event

A pregnancy which grows in any other place outside the uterus is called an Ectopic pregnancy. The commonest site for an ectopic pregnancy is in the tube. The pregnancy continues to grow there but as the tube can’t expand beyond a certain limit, it ruptures. This leads to torrential internal bleeding, which may not be visible externally at all. At times when the pregnancy test is positive, most women safely take it for granted that all must be well. However, a few women who actually experience an ectopic pregnancy in their lifetime will vouch that it is not safe to assume so.

When a woman misses her monthly period, and the pregnancy test is positive, the site of the pregnancy must be confirmed by an examination or an ultrasound.

We present a patient who was pregnant and who has bleeding after 6 weeks and assumed that she had a miscarriage. However, this mild bleeding is also seen in an ectopic pregnancy. The pregnancy continued at the junction of the uterus and her tube and one fine day, 7 weeks later, burst!!

She reached the hospital in pain and in a breathless condition. The symptoms were only for a few hours but she looked very pale. Ultrasound was not Confirmatory. Dr. Siddesh Iyer, the consultant Gynaecologist immediately diagnosed the case as ectopic pregnancy on history and clinical examination. When urine pregnancy test was done, it still was positive (which should have been negative assuming she had a miscarriage 3 weeks ago) , and the diagnosis was confirmed.

• She was immediately taken for emergency surgery. She had 3 and half liters of blood in her abdomen. Including 100 grams of blood clots. The tube had burst at the cornual region (junction of the tube and the uterus) and was still bleeding profusely.
• The bleeding was controlled and the condition started to improve.
• She needed 3 bottles of blood and 4 fresh frozen plasma. She stayed in the ICU for 2 days..
• She was kept in wards for another 2 days and was discharged on day 4.
• Stitch removal was done on day 9 and the stitches were healthy.