What happens during and after an ectopic pregnancy - Nur Salwan and Najwa's experience

30 Jul 2022 01:01pm
A 3D illustration showing an 7-week fetus implanted in the fallopian tube instead of uterus. (123rf)
A 3D illustration showing an 7-week fetus implanted in the fallopian tube instead of uterus. (123rf)

An ectopic pregnancy happens when a fertilised egg grows outside of the uterus or womb.

According to Health Ministry's MyHealth website, this type of pregnancy occurs in one to two per cent of all pregnancies and of these 98 per cent implants in the fallopian tube. Other sites for ectopic pregnancy include abdominal cavity, ovaries, cornu of the uterus and cervix.

A ruptured ectopic pregnancy is a life threatening condition and it is the number one cause of death in women who are in the first three months of pregnancy.

In most cases, the embryo, which is implanted in the lining of the fallopian tube would burrow into the tubal lining and cause bleeding.

As the embryo increases in size, the fallopian tube is stretched and it may rupture, causing extremely heavy bleeding into the abdominal cavity and threaten the life of the woman.

Early diagnosis and treatment in a hospital is necessary.

To understand what happens to women experiencing this, Sinar Daily talks Nur Salwan Gashlan and Najwa Arifah Ismail.

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Not a pregnancy but unfortunately the opposite Nur Salwan bears her soul in this interview, believing that "it's time" to tell the scariest and most heartbreaking thing that has ever happened to her.

The 32-year old linguistic lecturer said she first discovered she had endometriosis cyst before she got married back in 2013.

Endometriosis does reduce chances of pregnancy, she said, where in later stages of the disease, scarring can cause structural changes like kinks in the fallopian tubes that prevent the sperm and egg from hooking up.

She said those complications can make it harder to get pregnant where overall 30 to 50 per cent of women with endometriosis experience infertility.

Despite knowledge of her health condition, Nur Salwan said it did not stop her husband from marrying her and advised by her gynecologist, she had a surgery to remove the cyst.

“We accepted that it might not ever happen for us – and that was okay.

“But in early 2016, we both agreed we wanted to try and it took us two months to get two lines (positive) on the testing kit but it was a faint one.

“I know we are very lucky to have gotten pregnant that fast, as many people struggle with fertility.

“However, I also learned that a faint line could mean I was pregnant and miscarried without knowing, or there are complications with the pregnancy,” she said.

Ecstatic about the good news, Nur Salwan described the early stages of her pregnancy with "classic symptoms" such as morning sicknesss and fatigue.

She said there was still the other side to her pregnancy - the anxiety-ridden side of things as she continued feeling cautiously optimistic, fearing of a miscrriage.

"Then, one day, this happened - I was bleeding, my pain intensified from a twwo when I entered the hospital escalated to seven over the course of a few hours.

"When we (she and her husband) finally saw an emergency doctor, she suspected it could be an ectopic pregnancy because the hCG levels in my blood were below the normal amount, and ordered an ultrasound and it looked most likely it.

Nur Salwan said her right fallopian tube was removed together with the embryo.

Questions of "Why me?", "Why did this happen" and "Why did I have to be that 1 per cent" continued to feed on her, she said and it took her some time recover and be at peace with herself.

Nur Salwan with her husband and two daughters.
Nur Salwan with her husband and two daughters.

However, despite having only one fallopian tube and other complications, she managed to conceive again three years later not only with one but two children.

Nur Salwan said she currently lives a healthily without any medications and an avid yoga practioner.

Meanwhile, 31-year old Najwa Arifah Ismail, who currently works as a legal immigration associate in Qatar, shares her traumatizing experience on ectopic pregnancy that nearly killed her.

She said she was three months pregnant at the time and during a check-up, her doctor could not find the baby in its place and suspected it was an ectopic pregnancy but brushed it saying that it could be due to the baby still being small.

This - obviously - was not the case and lost one of her fallopian tubes soon after.

“It happened a week after Hari Raya Aidilfitri in 2020 and I was at my in laws’ house and I had an extremely painful stomachache and didn’t suspect anything.

“Suddenly, I had blood gushing out from my body and forced myself to go to my husband, I told him it was so painful.

“I was brought to the emergency room, they said I had lost almost a litre of blood. If we had come in any later, I probably couldn’t be saved. I went through so much unspeakable pain and had to undergo a C-section surgery to remove the burst tube since it has exploded in my body,” she said.

Najwa said she informed that the doctor who had initially suspected the ectopic pregnancy could have prevented it by carrying out minor procedure by vacuuming it out.

She, who is the eighth child from nine siblings, said it felt like the end of the world for her after that happened and now, only having survived with one fallopian tube - she has less chances on conceiving.

She said she often had recurring memories of being rushed to the emergency room when she sits in the car despite continously putting on a brave face daily.

Moreover, Najwa said the ectopic pregnancy had caused changes in her body including excruciating period pain that she has never experienced before as well as back pains and leg cramps.

"It was life changing.

“There are also people who didn’t put themselves in my shoes decided to invalidate my feelings and some said it was just a miscarriage when what I had to experience was very life threatening.

“Not only the blood gushed out from my body but also inside me. I was so angry when they invalidated my feelings and brushed off my pain,” she said.

Nevertheless, almost two years on, Najwa said she was now more accepting as there must have been good things ahead as God was the best of planners.

Najwa Arifah says she feels grateful for having supportive families and in laws throughout her post-ectopic pregnancy experience.
Najwa Arifah says she feels grateful for having supportive families and in laws throughout her post-ectopic pregnancy experience.

She said it was a hard journey but somehow glad at how become today.

“I’m extremely grateful for having a supportive family, in-laws, my friends and especially my husband. They never pushed us to try for another child and that is what makes me grateful.

“If there are women experienced ectopic pregnancy, please remember that it’s important to remember the support system we have and also make sure to be healthy again.

“Understand that thing had burst in your body, it takes time to heal and what’s most important is to not rush in having second pregnancy,” she said.