Staring at death with a bundle of joy

Mable Twegumye Zake's #BitsOfMe&You

Bits of ME

The clock of death for my close friend Brenda Namusoga (not real name) 34, was ticking to its end, before she even discovered a life growing inside her. Unknown to the bubbly full of life teacher…she was a dead woman walking.

With her watering can in the right hand that morning ready to give life to her compound plants, Namusoga adoringly run her left hand on the ‘ungrown’ belly looking forward to the life changing 8-months ahead.

She was closing in on month one of her pregnancy after a positive test two weeks before. Suddenly, her day-dream was interrupted! A sharp cutting agonizing pain in her lower abdomen was not going away and threatened to go with her life!

Her writhing screams could have awakened the quiet neighbourhood. The persistent severe pain continued to plough her body, digging up every point of discomfort.

She was staring into death…did she know? No, she didn’t!

When the distress call came in that ‘Namusoga's life is hanging by the thread, we were numb.

I had last spoken to her the night before via call and all was well.

Bits of YOU

She was suffering with ectopic pregnancy, when the pregnancy develops outside the uterus.

Namusoga's pregnancy had grown in her right fallopian tube according to Dr. Tom Ssenkungu a gynecologist at Florence Medical Center.

Her fallopian tube had ruptured which explained the earlier sharp cutting excruciating pain in her right abdomen.

While naturally the uterus allows the pregnancy to expand, the fallopian tube is small and narrow not designed to enlarge.

“If the pregnancy grows in the tube, it is called a tubal pregnancy. When the tube begins to expand, it bursts, then you bleed internally and die in a very short time,” Dr Ssenkungu said.

He adds that the sperm can also fertilize the egg within the ovary; ovarian pregnancy or in the abdomen.

Whereas a pregnancy which grows in the abdomen can survive, Dr. Ssenkungu said that the others if not detected early for alternative treatment or removal, need to be surgically removed usually along with the affected fallopian tube/ovary.

“If there is an infection within the tubes, it becomes difficult for the fertilized embryo to travel from where it is, back to the uterus where conception is designed to occur”, Dr. Ssenkungu explained.

“So if the 72-hour period elapses before it reaches the uterus, it settles and conception takes place either in the tube/ovaries/abdomen.”

Other than patients with long fallopian tubes through which the embryo might fail to travel within the 72-hour window to cause an ectopic pregnancy, pelvic Inflammatory Infections largely cause ectopic pregnancies.

The growing danger

The failure to fully treat an infection can cause blockages (blocked tubes) within the tubes which Dr. Ssenkungu says, make it difficult for the fertilized embryo to travel back smoothly to the uterus.

“Due to an infection, germs can enter the reproductive system affecting it and causing adhesions or narrowing. While the person could heal following treatment, the tubes might not heal completely. The roughness or scarring within the tubes makes the journey strenuous for the embryo,” Dr. Ssenkungu said.

In the case of Namusoga who was rushed straight into Dr. Ssenkungu’s emergency theatre for surgery, tubal removal was the option since her right fallopian tube had burst open.

She lived to tell her story and still bears another healthy fallopian tube to try for another baby but not many women have been lucky.

If the doctor's assessment signals that an attempt to repair the affected fallopian tube will cause a high reoccurrence of an ectopic pregnancy, then the tube is removed.

However, doctors often attempt to repair the fallopian tube or ‘milk out' the pregnancy out of the tube in early detection.

Dr. Ssenkungu revealed a surge in ectopic pregnancies attributing them to an increase in the prevalence of pelvic inflammatory infections which are poorly treated placing many women at risk.

“Here at the medical center, we get at least 1 or 2 cases of ectopic pregnancies every month. Because of the poor economy, many women today fail to maintain proper hygiene or treat the infections,” he said.

Dr. Ssenkungu says upon testing positive for pregnancy, after the first two weeks, pregnant mothers should conduct an early scan immediately to detect the location of the pregnancy to counter the risks.

Symptoms of an ectopic pregnancy

  • Look for palmar pallor (unusual paleness of the skin on the palm) or if it’s paper white
  • Belly or abdominal pain
  • Virginal bleeding not related to a period
  • Body weakness
  • Faintness

Causes of Infections

  • Poor virginal hygiene (improper cleaning/bathing)
  • Poor menstrual hygiene
  • Dirty underwear/failure to buy new underwear periodically
  • STIs (which cause inflammation within the pelvis)
  • Having multiple partners who carry chlamydia bacteria infections
  • Past abdominal surgeries that caused adhesions etc

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