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Badilisha Lugha KISWAHILI

Doctors shed light on ectopic pregnancies plus miracle baby

3rd March 2012
Okolewa Amon holds his miracle baby at the Mission Mikocheni Hospital

Wonders will never end! Miracles still happen under the sun whereby you may have never heard that a pregnant mother had carried a baby for almost nine months outside her womb.

Just imagine that you went for testing and the doctor comes tells you that the baby you are carrying is being implanted somewhere outside the uterus.

One of the scariest things to discover early in the first trimester is an ectopic pregnancy. This complication also known as tubal pregnancy occurs when the newly-conceived baby implants somewhere outside the uterus.

You may also be going through a physical recovery yourself, especially if you needed surgery. Be sure to take the time to truly recover, don’t push yourself too hard or expect too much from yourself.

Your partner may also be grieving but may not show it as readily as you. Remember that he was probably first scared that he would lose you and needs time to process that.

His grief may come in time, even if you don't see it right away. It is normal and natural to grieve, but if you feel overwhelmed by your emotions you can always seek help. Talk to a trusted friend or family member; seek a clergyman or counselor experienced in helping women work through pregnancy loss.

“We first learnt the news that the baby my wife was carrying was located outside the womb, when she visited Mwananyamala hospital, four months into the pregnancy.”

This is how 33-year old Okolewa Amon, father of the miracle baby born at Mission Mikocheni Hospital last week begins the narration into the nine-month ordeal that his wife Elizabeth endured, carrying the ectopic pregnancy to full term in one of her fallopian tubes. It was her first pregnancy after their nine-year marriage.

Amon has just returned from  Iringa where went to burry his wife. He still looks confused from the loss of his dear wife.

The doctors phoned later directing his wife to go back for screening, after which they reassured her that the baby was in a normal position.

“After being told that my wife had no problem, she continued attending clinics as usual,” Amon says.

As the pregnancy developed, his wife started experiencing stomach pains, forcing her to go to Mwananyamala hospital for checkup. To their shock, they were told that the baby was formed outside the womb.

Amon was told to pay 250, 000/- for his wife to undergo an operation to terminate the ectopic pregnancy which left him worried that he could lose both the wife and the baby because he had no even a single cent.

  That is when he decided to call a friend who is a doctor at Mikocheni Mission Hospital and informed him of his situation. The doctor advised him to go for another checkup at Mikocheni before undergoing the operation.

A similar problem was identified at Mikocheni hospital and here things were tougher as he was told to pay 700,000/- for the wife to undergo the operation. He asked doctors for help since he did not have a single cent in his pocket.

God is always great because the hospital administration finally agreed to conduct the operation free-of-charge.

Amon takes time to respond when you ask him how he felt when was told that his wife had died from over bleeding, but that the baby was alive.

“I wished that I could have done something to save her. But God spared the baby. A miracle, for he had been destined to die, living and growing outside his mother’s womb as he did for nine months,” says Amon, who expresses his gratitude to Mikocheni Mission Hospital’s doctors and the entire management for successfully delivering the baby alive and healthy.

Amon, who works as a hired hand in long-distance trucks, appeals to good Samaritans to assist him financially to meet the baby’s requirements including purchasing infant formula.

Esili Amon, Okolewa’s brother, has volunteered to take care of the baby until his father is able to care of him.

As a brother, he says that he felt sad of what happened to Okolewa, adding that the loss of his wife was devastating, but nothing can be done about it.

Esili and his wife have decided to take care of the baby until the father is in a positon to do so, saying that the hospital has agreed to keep the baby under its care for another week as they prepare to handle the situation.

According to the Mission Mikocheni hospital doctors who worked on the case, foetuses formed out of ectopic conception are abnormal and very rarely develop into full term.

Dr Asser Mchomvu says most babies born in such circumstances are always malformed (disabled) and very rarely stay alive…so what has happened, one could say was a miracle in the country because such occurrences are very rare,” he says, adding that the baby scored ten points.

In a normal pregnancy, he says, 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 it developed fully to the child.

Mchomvu mentions 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, he says.

Such are the classical conditions under which ectopic pregnancy occurs and in such circumstances the embryo does not develop into a live birth.

“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 says.

This kind of 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.

The signs and symptoms of such pregnancies are very difficult to diagnose because they often mirror those of a normal early pregnancy.

These can include missed periods, breast tenderness, nausea, vomiting, fatigue or frequent urination.

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).

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.

Dr Mchomvu says that it is not always obvious that a pregnancy is ectopic. Some women do not even realize they are pregnant. The pregnancy hormone HCG or human chorionic gonadotropin normally rises in a predictable pattern throughout the early weeks of pregnancy.

This hormone is what a pregnancy test picks up and reads. When a pregnancy is ectopic, HCG may not rise normally and cause a pregnancy test to come back negative.

If a pregnancy test is positive but a tubal pregnancy is suspected careful monitoring of HCG levels is important. Often, however, a woman will not have any reason to suspect ectopic pregnancy unless she has had one before. The first warning signs may be bleeding and abdominal pain.

Ultrasound can be used to detect an ectopic pregnancy at around 5-6 weeks after conception. Sometimes a laparoscopy, or a tiny camera inserted into the abdomen through an incision, is used to get a clearer look. If a gestational sac is not detected in the uterus there will be a careful examination of the fallopian tubes and the rest of the abdomen to find where the pregnancy has implanted.

If it is not diagnosed and treated an ectopic pregnancy can cause the fallopian tube to rupture, resulting in large amounts of internal bleeding. Ectopic pregnancy is life threatening. If you suspect it, get to the hospital immediately.

Sometimes it cannot be prevented, but there are things you can do to lessen the chance of ectopic pregnancy. If you've had one in the past your risk is higher, but many women go on to have a healthy pregnancy even after a loss from ectopic pregnancy.

First avoid risky sexual behavior. Sexually transmitted disease account for a large percentage of ectopic pregnancies.

It seems counter-intuitive, but if you think that you may possibly want to become pregnant ever again, do not have a tubal ligation. Having one increases your chances of ectopic pregnancy and having it reversed increases your chances.

Do not smoke. Smoking can damage the ampulla of the of the fallopian tubes. These important little "fingers" help push the fertilized egg down into the uterus.

Note that some forms of assisted reproductive technology increase the risk of ectopic pregnancy. Those where the egg is fertilized outside of the body carry a slightly increased risk. Drugs that induce massive ovulation also carry some risk.

Another suggestion is to take the time to make sure your hormones are balanced before you try to conceive. This increases the odds that everything occurs as it should with implantation. You may wish to seek the help of a doctor or midwife experienced in helping women regulate their hormonal cycles.

If you have had a tubal pregnancy you have suffered a loss. Your baby may have been very real to you and was very wanted. You should not feel ashamed or bad for taking the time that you need to grieve your child.

Even if you have had an ectopic pregnancy loss, you will probably be able to go on to have another baby. It is still OK to mourn your loss of this baby, however. Take the time that you need to heal and then make your choice about trying to conceive when you feel physically and emotionally ready.

The weighed 2.6 kilos miracle baby boy was successfully delivered through caesarian operation at Mikocheni Mission Hospital in Dar es Salaam last week.

However, the mother who miraculously carried the baby outside her womb for nine months succumbed to death shortly after the operation from over bleeding. The baby has since been under care of the hospital, where he is reportedly doing well.

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