Can a tubal pregnancy be moved into the uterus and be saved?
First, a little about tubal pregnancies; they are just one form of ectopic pregnancy. Ectopic is from the Latin "ek," meaning out of and "topos," meaning place. These "out of place" pregnancies occur whenever a pregnancy doesn't implant in the uterus. A new pregnancy must set up house in the uterus to survive. The uterus is the only organ that can successfully expand to accommodate the enlarging pregnancy.
Ectopic pregnancies occur in about one in a hundred pregnancies. The tube is the most likely site for an ectopic because the egg is usually fertilized in the tube by the sperm. The reason why a pregnancy doesn't make it to the womb and starts out elsewhere are several. Scar tissue is probably the most common cause. This can be from prior surgery, previous infections of the tube or from endometriosis. Fibroids, a very common benign growth on the uterus can compress the tube. Occasionally, a developmental abnormality of the female organs can predispose one to an ectopic pregnancy.
A pregnancy in the tube is now generally treated wit a laparoscope. This is possible if the tube hasn't already burst and the woman is not bleeding inside the abdomen. For those of you that don't know what a laparoscope is, it is a fiber optic device similar to the viewer you may have in your front door, but the laparoscope is longer and it directs light into the abdomen so the pelvic organs can be seen. In the past, the tube was always completely removed. Now, if possible, the tube is left because even though there is an increased likelihood of that tube having a problem again, very frequently the tube will function normally next time. This preserves the woman's fertility, but she must be seen early on and evaluated for a recurrence in subsequent pregnancies.
The other more unusual places an ectopic may occur are on the ovary or in the cervix. These can be very complicated cases. The most unusual form of ectopic is the abdominal pregnancy. The pregnancy attaches to some intra-abdominal structure (bowel, bladder, etc.) and is outside of the womb and just floating in the abdomen. These pregnancies can go to term and then must be delivered surgically. Abdominal ectopic pregnancies is how the very rare patient will get pregnant after a hysterectomy!
FRED CREUTZMANN, M.D. – CARROLLTON - 972-394-7277 or www.DrCmd.com