I need to know a little more about this for my MC. Is it possible that a doctor would advise a patient to undergo a drastic procedure to stop further dangerous, life-threatening pregnancies? I did some research but the result was inconclusive. I suppose I should interview a doctor but I am too shy. I thought to ask first the good people from AW. Midwife, are you around?
Thank you all,
Adagio
Hi Adagio,
I am not quite sure what you are asking and I am not a surgeon, but I will do my best to give you some background (from my fresh review of the chapter in Williams' Obstetrics--the OB/GYN Bible). Also, I am on call so I may post part of my answer now and part later.
Ectopic pregancies can be found in a myriad of locations. We often think "tubal", but they can be implanted on the ovary, the broad ligament in the pelvis, the cervix, and many places in the abdomen.
There are some factors that increase a woman's chance of having an ectopic pregnancy.
--tubal ligation or repair of tubal ligation
--previous ectopic
--in utero DES exposure (many of these women are at the end of their reproductive lives)
--IUD
--progesterone only birth control pills
--tubal pathology--damage caused by endometriosis, pelvic inflammatory disease (STDs), other damage from even something like appendicitis
--assisted reproduction (IVF and other fertility interventions)
Ectopic pregnancies can:
--resolve on their own
--extrude from whereever they are and reimplant in the uterus (rare, but kinda cool, I thought)
--be treated with methotrexate or other medications (usually less than 6 weeks gestation)
--rupture (this is your life-threatening problem)
--need to be removed and can necessitate hysterectomy (removal of the uterus)
--grow to term or near term and be delivered (very very very rare and totally depends on implantation site)
So, what would help me answer your question is: what kind of radical procedure do you propose? The most reliable birth control options (tubal ligation and IUDs) increase the risk for ectopic pregnancies. Even a hysterectomy is not perfect. There have been cases where a woman has had her uterus removed but a fistula (opening) in the vagina forms allowing sperm to swim up, fertilize an egg, and become an ectopic pregnancy. To really be FOR SURE, the ovaries would need to be removed, which is radical, or simply no intercourse. Taking out a woman's ovaries would be very extreme.
I hope this helps, and if you could be a little more specific on what you want to have offered to your MC, I might be able to help more.