Miracle baby survives abdominal pregnancy
August 23, 2005
Ontario doctors say the case is so rare they won't likely see another in their lifetimes
Doctors in London, Ont., have witnessed something they expect never to see again in their lifetimes: A baby born after developing in her mother's abdomen instead of the uterus.
Dr. Victor Han, chairman of the division of neonatal-perinatal medicine at St. Joseph's Health Care, says there have been only four similar cases reported worldwide. "We won't see another case like this in my lifetime. A case like this won't happen in the lifetime of my colleagues either. Probably not even in Canada. It is so rare."
Emylea, daughter of Lia Tharby and Todd Miller of London, was delivered at 33 weeks by caesarean section on April 30. Surgeons found the umbilical cord was attached to the outside of the uterus and the baby was floating in the 28-year-old mother's abdominal cavity.
During development, the baby's head was under the liver, but the resulting flattening of her skull is now correcting itself. She will, however, require surgery for a dislocated hip as well as casting and bracing for her feet, which were both twisted to the right.
Surgeons removed Tharby's uterus to avoid the severe bleeding that might have occurred had they tried to separate it from the placenta, the organ that supplies the fetus with blood and nutrients.
Han says the abdominal pregnancy may have started because fertilization occurred outside the fallopian tube or because the embryo moved away from the tube within the first three weeks of pregnancy.
Had the condition been recognized early, the pregnancy would have been terminated, but a succession of ultrasounds failed to reveal the baby was developing outside the uterus, despite the fact Tharby was in and out of hospital with severe abdominal pain from the beginning of her pregnancy.
During the 33rd week, the baby's heartbeat slowed, prompting Dr. Renato Natale, associate chief of obstetrics at St. Joseph's Health Care and the London Health Sciences Centre, to order an MRI scan that left him suspecting something wasn't quite right. After consultation with the mother, an emergency caesarean section was performed.
Han says the pregnancy was possible because the placenta attached itself to the outside of the uterus, rather than another organ. But he adds the pregnancy clashes with current thinking on how the placenta develops.
"There is no question Emylea is a real miracle."
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Miracle baby survives abdominal pregnancy
