A 30-year old expectant mother was admitted to Mayanei Hayeshua Medical Centre, carrying one embryo inside her uterus and another one outside of it, endangering her life so that she had no choice but to give him up. The surviving baby’s due date is in May.
A rare case of a simultaneously regular and ectopic pregnancy with multiples was diagnosed and treated in Mayanei Hayeshua. The pregnant mother was forced to make the difficult decision of giving up the baby who was developing outside the uterus in order to save her own life and that of the other baby.
A thirty-year old woman was admitted to Mayanei Hayeshua about a month ago. Married and with one daughter, she was now in the early stages of her second pregnancy with what she thought was only one baby. She approached Mayanei Hayeshua’s doctors after feeling severe abdominal pain. An ultrasound revealed the reason for the pain: she was, in fact, pregnant with twins, yet while one was developing normally inside her uterus, the other had remained inside one of the fallopian tubes.
Dr. Baruch Messing, ultrasound specialist, was the one to diagnose this unusual pregnancy. Surprised at the findings, he called other specialists in as well.
“This is a very rare scenario which occurs in only one in every thirty thousand spontaneous twin pregnancies – as this one is,” explains Professor Gabriel Elsner, Director of the hospital’s Gynecology Ward. “In this particular case, two eggs were fertilized. One found its way to the uterus, while the other one ‘got stuck’ in the fallopian tube; perhaps due to some inflammation which prevented it from traveling to the uterus.” This kind of pregnancy poses an immediate threat to the mother’s life. The embryo developing inside the fallopian tube may cause blood vessels to rupture and lead to excessive bleeding. The fallopian tube must be removed and the ectopic pregnancy terminated. It is a challenging procedure, as doctors must be careful not to cause bleeding or damage to the healthily developing embryo inside the uterus.
The mother, in essence, was forced to give up one of her babies. “We suggested a laparoscopic surgery, during which we make a small incision in the abdominal wall, insert a loop and use it to isolate the fallopian tube and remove it carefully so as not to damage the uterus or cause bleeding,” Prof. Elsner explains.
He adds, “The procedure was done with a lot of skill and special care. Within an hour, the woman was past the procedure. A follow-up ultrasound of the remaining twin inside her uterus showed that he was not harmed and the embryo continues to develop and grow properly.”
The mother is now in her twenty-third week of pregnancy, and is planning on a normal delivery this coming March. She was discharged two days after the procedure, and may go on to have additional children if she so chooses. Prof. Elsner affirms that it is rare for pregnancy termination to end this way, with the second embryo remaining completely unharmed.
In the last week of November 2019, Professor Rael Strous, the South African-born medical director of Mayanei Hayeshua’s Mental Health Centre, and professor of psychiatry at Tel Aviv University’s Faculty of Medicine, was in London for a busy round of meetings and events organised by the British Friends of Mayanei Hayeshua.