“My baby was growing outside my womb”

Holly Jean Aroozoo-Clarke lost her baby and nearly her life, too ― she opens up about her ectopic pregnancy.

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"I’ve always known motherhood was a journey I was destined for. However, after our wedding in 2013, my husband, David, suggested we take a year for ourselves before starting a family. So, I waited patiently, albeit grudgingly, all the while buying baby-products on the sly and stashing it where the hubs wouldn’t find them.

Once the “baby ban” was lifted, we started the horizontal mambo, stat. I charted my basal body temperature and timed my ovulation furiously. Every month, I would take a pregnancy test and look out for signs and symptoms. Every month, the test would come back negative ― it was frustrating.

Much to my elation, we finally conceived after a year. However, my HCG (human chorionic gonadotropin) levels ― which calculates my pregnancy hormones ― were on the low side. The higher the HCG level, the stronger the pregnancy. Plus, I was bleeding like I was having a normal period.

Since I was only five to six weeks along, the scan wasn’t clear enough. My gynae said it could be a late implantation, so I had a progesterone jab every three days to support my pregnancy, in case it was still viable.

What happened the next couple of weeks was harrowing. My HCG levels started doubling initially, but then dropped at week seven. Since no gestational sac showed up on my scan, my doctor was convinced I was miscarrying.

To speed up the process of the miscarriage, I was given Cytotec, a medication that’s meant to contract your uterus and expel the lining, very similar to an induced abortion. I was supposed to take four doses within the next two days and was warned of heavy bleeding and bad cramps.

“Ectopic pregnancies have no chance of surviving. If the baby grows bigger, it will rupture my tube and I will need emergency surgery, or worse bleed to death.”

I didn’t feel anything after taking the first two doses that day. Nothing happened the next day either, after doses three and four ― not even a cramp. I went back to the docs for the HCG test and the levels turned out to be higher than before I took the Cytotec!

Bewildered, we did another scan and were finally able to see the gestational sac. However, it was nestled on my right fallopian tube instead of my uterus ― it was an ectopic pregnancy.

Ectopic pregnancies have no chance of surviving. If the baby grows bigger, it will rupture my tube and I will need emergency surgery, or worse, bleed to death. I had to make a decision fast on how I wanted to terminate the pregnancy ― either have keyhole surgery to remove the sac or get a methotrexate (MTX) injection. The latter is a chemotherapy agent used to treat cancer. MTX, which can only be done in the early stages of an ectopic pregnancy, has side effects but is less invasive than keyhole surgery, so I wouldn’t risk damaging my tubes."

Read on to find out which treatment Holly Jean ended up choosing…

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"It was a gruelling decision to make, one I had to do on my own as David was away on a business trip and I didn’t want to worry my family, since my dad was in hospital with dengue fever at the same time. It was a lonely, scary and emotional time.

I chose MTX ― the lesser of two evils. The injection hurt, because it's intramuscular, but as soon as the nurse removed the needle, I felt lighter instantly. A wave of relief overcame me ― it was done, my life was no longer in jeopardy…unfortunately, I no longer had a baby either.

The procedure knocked the wind out of me. I felt nauseous, drained and tired all day. I thought I was strong enough to handle it, but what happened that day was a humbling reminder that I’m only human.

“A wave of relief overcame me ― it was done, my life was no longer in jeopardy…unfortunately, I no longer had a baby either.”

Two weeks later, when I went for a HCG check, it was back to pre-pregnancy levels. We had to wait three months before we could try to conceive again to make sure that the MTX was out of my system as it can cause foetal abnormalities.

I fell pregnant the very month I tried ― hurray! But we were cautiously optimistic, as the risk of having an ectopic pregnancy is higher once you’ve had one. I only allowed myself to rejoice after my pregnancy received a clean bill of health.

Nine months later, we welcomed our rainbow baby, Myla Rae. Not everyone’s ectopic pregnancy story has a happy ending, so I will forever be grateful for my ‘gift’, plus a wonderful doctor who kept a close eye on my pregnancy and detected the issue quickly."

Holly Jean Aroozoo-Clarke, 36, a blogger and SAHM, lives with her husband David Clarke, 47, and daughter Myla, 9 months, in Novena.

Continue reading for a lowdown on ectopic pregnancies…

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Facts about ectopic pregnancy

  • An ectopic pregnancy occurs when an embryo implants outside the uterus where it should normally implant.
  • This usually occurs in one of the fallopian tubes tubes carrying the eggs from the ovaries. Very rarely, an ectopic pregnancy can also occur elsewhere in the abdominal cavity, ovary or neck of the uterus (cervix).
  • An estimated 20 out of 1,000 or 2 per cent of pregnancies are ectopic.
  • This complication can be detected around the fifth or sixth week of gestation, when the sac can be seen on an ultrasound scan.
  • It’s usually caused by damage in the fallopian tube from a previous infection, inflammation or surgery, hormonal imbalances or the abnormal development of the embryo. The risks also increase if you fall pregnant when using an intrauterine device (IUD) or after a tubal ligation.
  • Symptoms include light vaginal bleeding with abdominal or pelvic pain. If the fallopian tube ruptures, serious internal bleeding inside the abdomen is likely, followed by light-headedness, fainting and shock.
  • In general, ectopic pregnancies cannot proceed normally. The embryo cannot survive outside the uterine cavity, and the growing pregnancy tissue might destroy various maternal structures. Left untreated, life-threatening blood loss and maternal death is possible.
  • There are two treatment options: In the first, a methotrexate injection is given to stop cell growth and dissolve existing cells. After the jab, you’ll need to continue monitoring the HCG (pregnancy hormone) level. If it remains high, you might need another injection of methotrexate. Alternatively, you can undergo laparoscopic surgery. In this procedure, after a small incision is made in the abdomen, a fine telescopic camera is inserted to view the area. The ectopic tissue is then removed and the fallopian tube repaired. If the fallopian tube is significantly damaged or ruptured, it might need to be removed.
  • If you opt for the methotrexate jab, it is advisable to wait for at least three months before trying for a baby as the drug can cause foetal abnormalities. If it was a surgical removal, a couple can safely try to conceive as soon as the woman has recovered from the surgery, which should be after one to two months.

Contributed by Dr Kelly Loi, a gynaecologist, obstetrician and IVF specialist at Health & Fertility Centre for Women.

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