Doctors in rare baby delivery
Doctors at Dar es Salaam Mission Mikocheni Hospital achieved a rare feat on Wednesday, when they delivered a baby who had grown to full term outside the mother’s womb.
The 2.5kg-baby boy grew in one of the mother’s fallopian tubes, a medical phenomenon termed ectopic pregnancy. The mother, Elizabeth Amon however died immediately after the caesarian operation from severe bleeding.
In an interview with The Guardian in Dar es Salaam yesterday, Mission Mikocheni Hospital Director General Dr Asser Mchomvu said after a careful investigation of the mother’s condition, they discovered that the baby was growing outside the uterus, a thing he said endangered not only the baby, but the mother too.
“Our doctors worked very hard on the operation on Wednesday struggling to save the mother and to safely deliver the baby. In other words they scored all the ten points that a new born baby must make upon delivery — which include breathing, reflexing, pulse and tone,” explained Dr Mchomvu, to journalists and Okolewa Amon the clearly distraught father of the three-day old now motherless toddler.
“Most babies born in such circumstances are always malformed and very rarely survive…so what has happened, one could say is a miracle in the country, because such occurrences are very rare,” he said.
In a normal pregnancy, he said, the fertilised egg is implanted and developed in the uterus, but in her case it was not. The fertilised egg settled in one of the fallopian tubes where the foetus developed fully into the 2.6kg-baby.
Explaining further on how ectopic pregnancies occur, Mchomvu said they are caused when a fertilised egg lodges in a fallopian tube instead of continuing its journey to the uterus, where it is supposed to implant.
Usually the egg is stuck when the tube is damaged, scarred or distorted.
Mchomvu mentioned some of the common conditions which increase the risk of ectopic pregnancy as tubal infections, pelvic inflammatory disease, chlamydia and gonorrhea.
Others are previous abdominal surgery especially involving the fallopian tubes, ovaries, uterus, lower abdomen, or bowels.
When the foetus grows, it will eventually burst the organ in which it is accommodated, he said, adding that this can cause severe bleeding and endanger a mother's life.
Such are the classical conditions under which ectopic pregnancy occurs and in such circumstances the embryo does not develop into a live birth, he said.
“That is why ectopic pregnancies are commonly called "tubal pregnancies"…the egg can also implant in the ovary, abdomen or the cervix, and these are respectively referred to as ovary, cervical or abdominal pregnancies,” Mchomvu said.
Pregnancies could develop in those organs, but the underlying problem is that none of them has as much space or nurturing tissue as the uterus for pregnancy to develop, he explained.
The signs and symptoms of such pregnancies are very difficult to diagnose because they often mirror those of a normal early pregnancy, he said.
These can include missed periods, breast tenderness, nausea, vomiting, fatigue or frequent urination, he said.
Pain and vaginal bleeding are often the first warning signs of ectopic pregnancy. There might be pain in the pelvis, abdomen or even shoulders or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves), he explained.
Mchomvu further noted that the pain can be mild or crampy early on, and can become sharp and stabbing. It may concentrate on one side of the pelvis, he added.