Baby Develops Outside the Womb and Delivered Surgically at 29 Weeks: How Often Does This Happen?

A French woman sought medical help for abdominal pain, only to discover she had a rare ectopic pregnancy. However, instead of growing in her uterus, scans revealed a 23-week-old baby in her abdominal cavity.

Woman Delivers Healthy Baby After High-Risk Ectopic Pregnancy

The woman described in a report published online on December 9 in The New England Journal of Medicine had been experiencing abdominal pain for ten days and decided to seek medical attention, where doctors suspected an ectopic pregnancy.

With two full-term deliveries and one miscarriage before this incident, the woman underwent an ultrasound and MRI, revealing a 23-week-old fetus growing in her abdomen, attached to the lining above her spine's base.

Due to the perceived high risk, she was transferred to a specialized hospital for careful monitoring in the final weeks of pregnancy. After six weeks, surgeons performed a laparotomy to deliver the baby, who was promptly transferred to a neonatal intensive care unit.

Babies born prematurely, defined as those arriving before 37 weeks of gestation, need specialized care due to their limited time for development within the womb. Nevertheless, a noteworthy statistic indicates that a substantial majority, ranging from 80% to 90%, of infants born after 28 weeks manage to survive.

The initial surgery removed part of the placenta, with the remaining portion extracted in a subsequent procedure. Twenty-five days post-birth, the woman was discharged from the hospital, and about a month later, she was able to bring the baby home.

Unfortunately, the case report notes that the woman and baby were "lost to follow-up," leaving medical professionals unaware of subsequent developments.

How Often Does Ectopic Pregnancy Happen?

In about 1% of pregnancies, the fertilized egg takes an uncommon path, bypassing the uterus and embedding itself in less conducive abdominal tissue for development. While most ectopic pregnancies occur in the fallopian tubes, risking both parent and child without prompt medical intervention, less than 1% involve the embryo settling in the abdominal cavity, creating a placenta against surrounding organs.

Despite its surprising initial viability, this arrangement becomes risky as the unsupported weight of the developing child and pressure from adjacent organs pose threats to both fetal growth and maternal health. Beyond 20 weeks, nearly one in five cases may lead to maternal death due to shock, hemorrhaging, or multiple organ failure.

Ectopic pregnancies cannot reach full term, posing significant risks such as organ rupture and infection for the pregnant person. The standard treatments involve surgical removal or the use of drugs to halt fetal growth.

The specific causes of these rare migrations remain unclear, but a history of previous cases and factors like sexually transmitted infections, endometriosis, and pelvic inflammatory disease may contribute to their occurrence.

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