A rare case of ectopic pregnancy in Ponta Porã, in the southern region of Mato Grosso do Sul, surprised doctors at the city’s regional hospital. An 81-year-old woman discovered that she had been carrying a calcified fetus for more than 56 years — the period in which she had her last pregnancy. The elderly woman, who was indigenous and lived in a settlement in the municipality of Areal Moreira, died after surgery to remove the fetus.
The patient was admitted to the hospital with a serious infection on March 14. On the same day, a 3D tomography scan found the fetus calcified in her abdomen. The institution’s obstetrics team was called and performed surgery to remove it, but the elderly woman died the next day after the removal surgery.
According to experts, the name of the condition is lithopedia, a type of ectopic pregnancy, that is, when the fertilized egg does not reach the uterus, becoming trapped in other places, such as the cervix or even the abdomen. In the case of the elderly woman, the fetus from an unrecognized abdominal pregnancy died and calcified inside the mother’s body.
What is ectopic pregnancy?
Despite being an uncommon condition, occurring in around 2% of pregnancies, it is the main cause of maternal mortality in the first trimester of pregnancy. Around 90% of ectopic pregnancies are tubal, that is, they occur in the tubes, which ends up resulting in an even greater danger for the woman.
The implanting embryo continues to grow in the narrow fallopian tube. After three weeks, the size of the embryo is enough to cause pressure inside the tube, capable of rupturing it, resulting in hemorrhage that can be fatal if not treated with surgery.
The main symptoms while the embryo grows in the tube are unilateral abdominal pain, vaginal bleeding and fainting. When there is a rupture, the signs intensify: the patient feels a sharp or tearing pain on one side of the abdomen, close to the groin, and presents a drop in blood pressure and other symptoms of shock.
Women who are most at risk of ectopic pregnancy are those who have had one previously, but there is also a high possibility in those with pelvic infections or previous uterine surgeries. In vitro fertilization also increases the chances of having an ectopic pregnancy. However, in half of the cases, the women were healthy and did not have any risk factors.
Treatment for this type of change will also depend on the pregnant woman’s health history and the risks of a possible rupture of the uterine tube. Generally, healthy women receive an injection of methotrexate, which is also used to treat certain types of cancer and autoimmune disorders and makes it difficult for cells to form DNA or multiply. With this medicine, the embryo stops growing, and the body ends up reabsorbing it.
If the tube ruptures, the pregnant woman must undergo emergency surgery, where the embryo is removed. In both cases, whether with surgery or injection, the gestation process is interrupted, which makes many people believe it is an abortion.
However, with or without intervention, ectopic pregnancies do not survive beyond the first few months. A fertilized egg is unlikely to survive for long outside the egg, as other structures in the body are not capable of protecting or nourishing an embryo.