Talk:Ectopic pregnancy

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I tried to find an academic reference for the Montreal 2003 case, but this was unsuccesful link. JFW | T@lk 12:20, 10 July 2005 (UTC)

Contents

[edit] "Viability of Pregnancies" heading?

I don't know if there is some kind of template or standard for medical articles, but I think it would be helpful if there was a heading for "Viability of Pregnancy". Whether or not one could actually deliver an "ectopically" implanted fetus was the first question I had when arriving at this article, especially with the arresting graphic at the top of the page ([1]). kostmo 08:04, 10 February 2007 (UTC)


This graphic is a fanciful depiction classical of the time it was created. The reality is that one does not see a nice fetus as shown, at most it is a little scrap of tissue, or just blood clot. I hope this helps your understanding. JustAnMD 03:49, 6 April 2007 (UTC)

Do you mean as in a parasitic twin, or as in not developed much? Can it be called a fetus if it's a blood clot? Junulo asked this question at 20:24, 7 November 2007 (UTC).

Good question. One rarely finds more than a blood clot, or the remains of the sac. The analogy with miscarraige is strong; the fetus being abnormal and not developing. ```` —Preceding unsigned comment added by JustAnMD (talk • contribs) 15:18, 10 November 2007 (UTC)


This story is apocryphal and does not merit inclusion in a serious discussion. Without strong and exact references, it should be removed. "Cases have been known where a tubal pregnancy burst and the pregnancy continued with the growing placenta attaching to internal organs. In one such case the pregnancy after this had no amniotic sac and the baby was loose among its mother's intestines; laparotomy rescued the baby, and it lived." I plan to allow time for response before removing it. ```` —Preceding unsigned comment added by JustAnMD (talk • contribs) 15:23, 10 November 2007 (UTC)

[edit] University of Iowa

I have removed this recent unsourced addition for now. It's just an anecdote and needs a citation. The style is not encyclopedic and it would need cleanup if added.

One such case was in Iowa, at the University of Iowa Hospitals, back in the 50s. To deliver an extra-uterine child via laprarotomy is something more than a one-in-a-million event. To hear a good emergency room nurse relate the story is magical: the whole of University of Iowa baby-deliverers were there in the room, observing and assisting at a majical event.

--Tony Sidaway 12:27, 13 March 2006 (UTC)

[edit] Catholic view

The Catholic view may belong in a larger section on the ethics of surgery in such cases. I have removed the recently added section because it is anecdotal and the writer does not seem to have even seen a good source ("apparently"). --Tony Sidaway 12:27, 13 March 2006 (UTC)


Obtaining accurate figures for the rates of ectopic pregnacy is impossible, since this is one of the few medical grounds on which a Catholic woman can have a pregnancy terminated : at one stage in the late 70s/early 80's, the rates of recorded ectopic pregnancies in the Republic of Ireland and Spain were so high, medical experts formed the opinion that there must be a genetic disposition towards them- the true reason was of course, falisfication of medical records.

Is there a way to save both the mother and child? —Preceding unsigned comment added by Junulo (talk • contribs) 20:25, 7 November 2007 (UTC)

[edit] New study information

http://news.bbc.co.uk/2/hi/health/5234838.stm

Someone who is interested in this topic might want to research this reported data. Figured it might help you out in the work here. ciao

[edit] statement with void content

"A classical ectopic pregnancy never develops into a live birth."

What does the word "classical" in this context denote. It severely undervalues the usefulness of the word "never" later in the sentence. Without any explanation of what makes an ectopic pregnancy classical, there is no logically sound way to assess what the sentence means. Am commenting it out, until something more sensible can replace it. -- Cimon Avaro; on a pogostick. 09:34, 6 October 2006 (UTC)

[edit] confused

I don't get it; why can't they just relocate the fetus to the uterus and re-implant it? I admit I'm not a doctor or anything, it just seems like in today's world, where we can implant other nerves into arms to create new artificial limbs it's weird we can't even relocate a fetus.--Anoma lee 03:15, 31 October 2006 (UTC)

-Because the placenta would have to be relocated as well. Detatching the placenta from its attachment site would destroy the blood vessels, making it useless. Sjc80 06:20, 13 January 2007 (UTC)

[edit] Author?

"In this author's experience this is invariably bowel or mesentery, but other sites, such as the renal (kidney), liver or hepatic (liver) artery or even aorta have been described. "

Wiki not place for origional research.. maybe it was copied from somewhere?

StarDolph 00:48, 29 November 2006 (UTC)


Hi, actually I am the author, with many years of experience in the Third World, and currently in practice in Canada. My department, with over thirty thousand deliveries a year, under adverse conditions, had likely the largest concurrent series of extrauterine pregnancy in the world. The insertions were as described, so I guess this is extensive personal experience. -- —Preceding unsigned comment added by JustAnMD (talk • contribs)

What about the statement of the possibility of male pregnancy. If that can't be supported with citations then it has to be removed. I am not, however, disagreeable to keeping the statement if a reasonably sizeable group has expressed such a view, evidence can be produce to show that they hold this view, and the statement is reflected as such. -*- u:Chazz/contact/t: 02:31, 3 December 2006 (UTC)

In response to Chazz88, this does worry me a bit. It is actually little more than science fiction, and is not to my knowlege the subject of serious research. Maybe it should go? ``` —Preceding unsigned comment added by JustAnMD (talk • contribs)

If you have an American M.D. and concur with my view then I would go ahead and delete the comment I refer to in my comment above. If, and when, evidence can be produced, as described in my comment above, regarding this issue then it can be re-inserted. Until now I think it is safe to delete it. -*- u:Chazz/contact/t: 20:27, 3 December 2006 (UTC)


Canadian will do? And specialty in OB/Gyn. I will take it out, but am new at this writing thing. —Preceding unsigned comment added by JustAnMd (talk • contribs)

I suppose it will have to. Just kidding! Ohh.. a tip for you. Sign your comments on talk pages by putting 4 tildes at the end (if in doubt see the information below the page you use to "edit" articles). Welcome to the Wikipedia project I am sure we could do with your support and knowledge. I would suggest that you read the some of the different Wikipedia project articles (i.e. those on how to write articles, what you can and can't write, basic ground rules and a lot more, the Wikipedia Comunity). Don't try and read them all, especially immediately as there are far too many! Just get accustommed with the basics. Can I suggest Community Portal, Wikipedia's Medicine Portal (OB/GYN and [Surger|surgery in general]] comes under the Portal's remit), Wikipedia's policies on [Wikipedia:No original research|original research]] (i.e. don't do it) what it isn't, neutrality, verifiability, citing sources and how to edit a page on Wikipedia. -*- u:Chazz/contact/t: 23:10, 3 December 2006 (UTC)

[edit] My story

I am a 38 year old, healthy woman. I was diagnosed with PID when I was 19 years old. At age 25 I had to have two large cysts removed from my ovaries (at that time my doctor decided to scrape the scar tissue from my tubes) At age 31 I had an ectopic pregnancy that ruptured. At the time, I knew what it was! I am intelligent enough to figure these things out. So, I requested that the doctors take my other healthy tube out. They did not because I was young and there was speculation that I may want children some day. We'll, only 3 years later, I had another ectopic pregnancy. This time rupturing an causing internal bleeding of more than a litter. I was going into shock before I went into surgery. My question is...Why won't doctors listen to their patients. Why did they take it upon themselves to leave my healthy tube, even after I specifically said that I did not want to have children and I did not want to have to worry about this happening again. In my view they are negligent, because I would never had had another one if they had done what I said. Another thing: Why do the emergency room staff treat patients like they do not know what they are talking about. It took them hours to get me in, by that time I was in shock! I told them what was going on, but they treated me like I had no clue. It is the information age, doctors should take their patients more seriously!

It is a very stirring story. I agree that doctors should take their patients more seriously. As a medicine student I'll try to remember your story, and have it in my mind when I'm a doctor myself. Mikael Häggström 18:06, 13 July 2007 (UTC)


    • I think that you just had some horrible doctors! I, too, had a similair story. At the age of 19, I had to have one of my tubes and ovarys taken out. I had my first daughter a couple years later in a very successful pregnancy (the delivery is another story entirely!). 3 years after that I had an ectopic pregnancy. Mine, thankfully, never ruptured anything, but I did have to stay in the hospital for a couple days. My doctor, knowing I was operating on one tube anyway, had suffered through a miscarriage previously, now the tubal, and had always had a lot of pelvic pain anyway, was going to go ahead and give me a partial hysterectomy; leave the ovary (so that I didn't go into early menopause-- at the time I was 26). My surgery was scheduled immediately after my ectopic, and my pregnancy levels were monitored every other day to ensure that my body had gotten rid of the embryo (after having an injection). 2 days before my surgery, my doctor calls me and tells me that he can't perform the surgery because I was pregnant! Somehow, miracously, I had gotten pregnant almost immediately after the ectopic. I was so scared, and upset, because I didn't want to go through what I had had already gone through. But, I'm happy to say that I have a very healthy 14 month old!! :) My pregnancy was amazing, so easy. I'm sorry to hear that you've been through all that you have, I know it's horrible!! But, maybe, someone else has a different plan for you?!?! :) He definetly did for me!! ~Amber —Preceding unsigned comment added by 68.51.113.233 (talk) 00:49, 18 December 2007 (UTC)

[edit] Thanks

To the author for such a well written article - We hope you'll be satisfied and not offended by the external link we have added? -

The Ectopic Pregnancy Trust is a source of information and support for those who have suffered the condition. The Charity is medically overseen and moderated, and though UK based, (recognised by the National Health Service(UK), Department of Health(UK), and The Royal College of Obstetricians and Gynaecologists(UK)) They serve the population of the web at large.

Many thousands now use this on line encyclopedia and the missions of the EPT, who provide afore mentioned resource: Is to raise awareness of ectopic pregnancy among health professionals and the general public: To offer support to people affected by the condition: And to support research in to early diagnosis. It provides telephone support and information from trained and qualified staff and connect users with others who have experienced ectopic pregnancy. It promotes research into the causes, treatment and prevention of ectopic pregnancy, and provides information Leaflets. Information is also available, along with message boards, on their website.

[edit] Causes

The causes of ectopic pregnancy are unknown. After fertilization of the oocyte in the peritoneal cavity, the egg takes about nine days to migrate down the tube to the uterine cavity at which time it implants. Wherever the embryo finds itself at that time, it will begin to implant.

Fertilization does not necessarily occur prior to the egg entering the oviduct; it can occur within the oviduct as well. As such, there are a number of problems with the statements made above:

  1. fertilization does not necessary occur within the peritoneal cavity.
  2. Is it the "taking of nine" days that stimulates the egg to implant or does it take nine days for the egg to travel the length of the oviduct? The comment that follows, wherever the embryo finds itself at that time, it will begin to implant suggests that the egg will implant 9 days post-fertilization. At which time it implants, however, is suggestive that entrance into the uterus is a stimulation for implantation, which would result in no ectopic implantations.

This paragraph should be edited to reflect physiologic accuracy and grammatical unambiguity. DRosenbach (Talk | Contribs) 20:26, 9 January 2008 (UTC)

[edit] Advanced Maternal Age?

The article says advanced maternal age is a risk factor. I have never heard this before and there is no citation for it. Can anyone provide a citation? If not, I will remove it. Nathanaver (talk) 20:04, 22 April 2008 (UTC)

[2] - I can't even see an abstract, so no idea what it contains. Still, the title kinda says everything, doesn't it? Though I'd be interested to know what their population and range of ages were. Also [3] WLU (talk) 20:53, 22 April 2008 (UTC)
Thanks, I will have a look at these later today. Just glancing at them, and a couple others I found, the discussion sections suggest that the authors believe that the increased risk is likely due to the cumulative effects of other things, like PID, not maternal age itself. Nathanaver (talk) 12:18, 23 April 2008 (UTC)

[edit] Nontubal ectopic pregnancy

Two parts of this section need a citation, If none can be found I think they should be deleted since they seem unlikely anyway. "While a fetus of ectopic pregnancy is typically not viable, very rarely, a live baby has been salvaged from an abdominal pregnancy." "Cases have been known where a tubal pregnancy burst and the pregnancy continued with the growing placenta attaching to internal organs. In one such case the pregnancy after this had no amniotic sac and the baby was loose among its mother's intestines; laparotomy rescued the baby, and it lived."

This last story seems very unlikely since a tubal rupture and ectopic pregnancy are leading causes of maternal deaths. No to mention that the baby living with out an amniotic sac is unlikely, especially after it would have to get cut from its implant site out side of the uterine wall.

I have never edited a Wiki article before let alone wrote anything in the discussion section, so I am afraid to look into this myself. I was simply researching and these seemed out of place and I was afraid that pro-life people may have edited this to try to misinform people about the severity of ectopic pregnancies and the need for removal of the pregnancy to prevent the death of the mother. —Preceding unsigned comment added by 76.219.160.103 (talk) 01:48, 3 May 2008 (UTC)

Actually, the first paragraph you bring up is cited - just not adjacent to the topic sentence. Check out references 4 and 5 - both are BBC News stories specifically referring to births where the fetus anchored in the abdominal area, in one case near the stomach and the other in the fat lining the bowel. Both citations are near the sentence claiming that there is little data except anecdotes due to the rarity of the condition. While the validity of a news source versus a medical journal may be questioned, the BBC is a reputable source of information and the references in question have stood since 2006. Specifically, the term 'abdominal pregnancy' is used in source 5. A medical source should be used for the initial citation, but it has been shown that the condition described does occur.
The second sentence you bring up seems to be a continuation of the concept in the paragraph, although it is written vaguely and lacks its own citation. Both would have to be fixed severely for the sentence to be usable in the article. I'm going to comment it out - JustAnMD brought it up as well last year and little progress has been made. It can always be reverted if needed.
Last, you do realize that most pro-life groups, including such entities as the Catholic Church mentioned earlier in this talk page, allow removal of ectopic pregnancies because of the risk to the mother, right? Both references refer to pregnancies where the ectopism was not recognized until the C-section was performed, else both would have been removed far earlier. Even with both remaining, the articles detail how the mothers needed surgical intervention and large amounts of transfused blood - the risks are pretty well codified there, not to mention earlier in the wiki article itself. Deciding that something should be removed because it might support someone else's position is bad on all sides. ZekeSulastin (talk) 20:58, 6 May 2008 (UTC)
I added an Associated Press story from Australia of an ectopic pregnancy in an ovary, in which a healthy 2.8 kg baby girl was delivered via Caesarean after a 38 week pregnancy. The story quotes the parents and a general manager of the hospital. I would look for additional sourcing to the doctor and in some medical journal. The ectopic nature of the pregnancy was not detected in exams during the pregnancy. Edison (talk) 14:17, 30 May 2008 (UTC)
Added more details: Quotes from the obstetrician who delivered the baby. Edison (talk) 18:29, 30 May 2008 (UTC)