For Sqad Or Any Med Professional Mainly - Ectopic Pregnanct Issue

[joko]

When i was about 24 (1994-5) I had an ectopic pregnancy.
I also have PCOS so it was a surprise.

I was in pain & had to go to hospital i think around 7-8 weeks
The docs did a D&C, then did a scan to check it was all gone - but i was still pregnant!
The scan showed a normal heartbeat in the uterus on the monitor!
The nurse was smiling & seemed to assume i was happy - it seemed like she hadn't checked why i was having the scan or something??
I was quite unnerved by her reaction, i didn't say anything to her.

So an abortion was scheduled for a date in the future & i went home.

I'm assuming the foetus didn't survive very long after that scan, as i know a D&C would be a traumatic procedure for it, & you can't move a foetus & replant it elsewhere, so it must have either been very firmly implanted in the first place & was only moved near the end of the D&C??
Or it somehow miraculously did implant??
Or it just survived long enough for the scan??

It was all a bit confusing, & when i went to have it removed, they didn't seem to know the situation either, & treated me like all the other women getting abortions.
1 or 2 nurses probably shouldn't have been on that ward, you could feel their disdain for the women.

I remember telling the surgeon, just before they knocked me out, that if the foetus is still there & ok, I don't want to keep it, & he just sort of smiled & said ok & just carried on what he was doing.

Looking back, it should have been clear to them that I didn't quite know what the plan was or what had happened to the foetus.
i assumed they were going to check to see if the foetus was OK first, & if not, they'd remove it, but if it was ok, they'd just send me home to carry on with the pregnancy!

I didn't realise i was in a specific proper abortion ward/clinic & they weren't checking anything, just doing the procedure, same as all the others.

That surgeon & other around must have wondered why I said that to him?
Even at that point, I still didn't know properly what was going on.


Is it possible for me to get more details of this from the hospital - like proper info - surely if it was so unusual, there'd be notes, right?
Unless someone thought they'd messed up the D&C so were vague??

I'd really like to know, because it seems an ectopic foetus surviving a D&C is considered basically impossible - so why was hardly anything said about it to me, it was all very perfunctory.
There was no sense of them being amazed.

Unless this is actually quite common & the impossible part is of it surviving for any length of time.

I felt very ill at home, waiting for the abortion, couldn't eat, could only eat, pineapple & jelly sweets.

I'd really like to know what happened - Ive downloaded my med history from my GP but its really terrible, very vague, hardly any info - and theres no record of the ectopic pregnancy, the D&D, the abortion etc - none of it!
Theres nothing there from before about 1995 - just allergies & immunisations.

GP notes were paper then - so were these notes just never copied over?

Any ideas what to do?

Or does anyone know of any similar cases where I get an idea of what likely happened to me?

I've googled but i'm not really sure what to look for, as i don't really know what happened

Thanks for any help
:)

[bednobs]

you can apply for your hospital notes

[bednobs]

you can usually also get your "lloyd george" (paper) notes from your heath authority

[jno]

I can't help directly but recently the local hospital wanted to carry out some procedure on me (I forget what) and I said "We've been through this before, about 1997." They had nothing in my digitised notes about it so they sent me home and looked through the old paper notes kept down in their basement somewhere. Nothing there either.

So I suspect a lot of paper notes got dumped without being copied. I hope someone can help with your medical query.

[LadyCG]

I had a right tube ectopic in 2016 which was treated with emergency laparoscopy and partial salpingectomy. I asked for a copy of the histology report following surgery which confirmed it was an ectopic in the right tube at the distal end.

Did they not explain the intra-operative findings or the procedure they carried out to you following surgery?

[bednobs]

PS. D+C is not the usual way of killing an ectopic pregnancy, in fact i dont think it's ever used for that

[bednobs]

and sorry i didnt mean to write killing, rather ending

[LadyCG]

These days they use Methotrexate if it's not life-threatening.

Unfortunately I had a bad internal bleed so emergency surgery was my only option.

BTW, there is no chance that an ectopic can move or be moved and then implant. There is 0% survival rate for an ectopic pregnancy.

[Sqad]

Why do you want to know?
In 1944 you clearly didn't have an ectopic pregnancy but it was most likely that the D&C was botched.
Can't you put this episode in your life to bed?

[joko]

I know they cant be moved and implanted - as i said in the OP - I know this was not alive in the sense of a viable pregnancy, it would not have survived - i know that.

The whole thing about them being unable to be removed & implanted, is impossible in terms of a doctor going in and doing it, & it working. I doubt there is much evidence regarding it happening naturally by chance.
I doubt it properly implanted - the scan was done soon after the procedure, so there wouldnt have been time for it to reimplant itself anyway.

I can only assume it just didnt die straight away after the procedure, just held on a bit longer? Maybe it was right at the entrance to the womb & was somehow in the uterus but still partially attached somewhere?

They didnt say very much about any of it tbh, there was no after care or follow up or explantions of anything.
All i know is the procedures I had & what was on the monitor.
Its all very weird.

Unless it was twins, and the viable one somehow escaped the procedure, which seems unlikely - but then if they were focussing on the fallopian tube & not looking for another foetus - perhaps they could have missed it?
i mean at 7 weeks it'd be barely visible against the uterus wall if you werent looking for it?

But if that was the case why wouldnt they say that?
Unless they just thought telling me would upset me?

[joko]

according to this theyre almost always done with an ectopic pregnancy - but not to treat it, more to diagnose it.
I assume mine diagnosed it but also 'luckily' cut out the need for other surgery by suctioning it out of the tube but not out of me...?

https://www.contemporaryobgyn.net/view/controversies-obgyn-dc-always-necessary-rule-out-ectopic-pregnancy

[LadyCG]

Pregnancy, whether normal or ectopic, tends to be confirmed by ultrasound scan and / or transvaginal scan (it was the latter that picked up my ectopic). There should be, somewhere, a USS report.

1994 is quite a long time ago so it would probably be a paper copy in the hospital notes (we don't bother filing paper copies these days as everything is electronic).

You would need to contact the hospital and go down the Permission to Copy route to get a copy of the ultrasound scan report and also the Op note from your procedure.

[LadyCG]

Joko, that link you provided mentions D&C to exclude a diagnosis of ectopic pregnancy, not to make a diagnosis of ectopic pregnancy.

You cannot "suction" a pregnancy out of a fallopian tube - you remove all of the tube (salpingectomy) or part of the tube (partial salpingectomy).

[ParsleyDumpling]

If you have changed GP surgeries since your procedures, then it's possible that your paper records have not yet been summarised. You can make a request to view these records (Lloyd George, as bednobs said), your GP should have them.

[joko]

Lady CG, thats what they said had happened.

If it wasnt ripped out of place by the suctioning, then its even more rare & unusual and actually a miracle because they did a D&C & there was still a live foetus in there - how can it still be there after theyve literally scraped the entire uterus out?
Thats impossible, but suctioning it along is not impossible, just very rare.

& why was i in so much agony on one side, then pain etc just gone?

Im pretty sure something 'unusual' happened somewhere here - not so unusual as docs to have made a fuss, but unexected & rare - I just dont know what or where

[joko]

Thanks all

Do hospitals keep more detailed notes than GPs?

My GPs notes are shockingly sparse, some entries i have no idea what i was there for!
so i imagine the GPs note about this would just be something like 'ectopic pregnancy. D&C. Abortion' or something equally useless - but the hosp might have recorded proper details?
Sure hospital notes are digitized by now?
They couldnt keep patient notes for 25 yrs in a folder in filing cabinet could they?
They'd need another wing to put it all!

[ParsleyDumpling]

Your hospital discharge summary would have been sent to your GP. It is entirely possible that your paper records have sat somewhere for 25 years. Mine have sat at my GP practice (which is now also my place of work), since the mid eighties. All paper records should be scanned into your notes and then destroyed, once scanned. A lot of medical information is now digital, but obviously this wasn't the case years ago. Some patients in our practice have a lot more than one Lloyd George, nowadays you would probably have an A4 folder for documents. Even if it's empty everyone has a Lloyd George (or should have).

[rowanwitch]

Just a couple of things I am not sure about from your post.
A D and C only clears the uterus
An ectopic pregnancy is one that implants outside the uterus ( usually in one of the fallopian tubes) so wouldn't be cleared by a D and C. An ectopic pregnancy is a medical emergency as it can rupture with severe blood loss, and would or result in at least small scars on your abdomen if it was dealt with laparascopically or a small surgical scar for an open procedure.

You really need to make an appointment with one of your team to go over your hospital. notes. You have obviously been given some conflicting information during this process. You describe a foetus with a heartbeat in the uterus. On a scan i.e a normally located one. Then you say you had a termination, but a D and C is functionally the same procedure so would already have removed anything in the uterus It doesn't sound like you had an ectopic as you haven't described the surgery that would have removed one.

You need to make a formal request to see your notes however the right only came in in 1998 so anything before that isn't covered by the rights under the data protection act.

[joko]

Thanks all

yes rowanwitch, thats the weird thing - it cant have been an ordinary pregnancy as i wouldnt have be having all the symptoms of ectopic, i was rushed to hospital in agony etc.
They do a D&C for ectopic pregnancies for diagnostic reasons, not to treat it.

D&C used suctioning, that power must have ripped the foetus from its place, and put it into the uterus - which is then why i only needed an ordinary abortion rather than specific ectopic surgery.
The foetus cannot have been in my uterus when i arrived because it would have been scraped out by the D&C.

It seems like it was just a fluke - that the foetus was right at the edge of the tube so it was easily dislodged by suction power.

all the pain & symptoms where gone pretty much immediately after the D&C
I just felt nauseated & tired while i waited for the abortion
I assume they couldnt do that so soon after a D&C so i had to wait until i'd healed.

The docs didnt make a fuss about it so i assume it just quite rare rather than impossible

[joko]

Does anyone know who you have make the requests to?
Is it just the hospital registrar or something?
or is there a special procedure?

[bednobs]

from your description, im not sure you did have an ectopic pregnancy