1719 illustration of an ectopic pregnancy in a tube.
Physicians have been aware of ectopic pregnancy since at least the 16th century. It's only in the last century that it has been treatable. And there's still a long way to go... Here's a brief history of ectopic pregnancy for #EctopicPregnancyAwarenessDay
Courtesy of Wellcome Images.
"Ectopic" means "out of place". An ectopic pregnancy forms when a fertilised egg implants somewhere that is not inside the uterus - most commonly the tubes, but other places such as the ovary, cervix, abdominal wall or C-section scars are possible.
Although it's called a pregnancy, in an ectopic pregnancy the embryo cannot develop into a baby, as this is only possible inside the uterus. The ectopic pregnancy cannot be moved to inside the uterus.
Ectopic pregnancy can be life-threatening. Only the uterus can support a growing foetus. Other organs are at risk of rupturing and causing lethal complications. About 1 in 80 pregnancies are ectopic, and require medical attention.
When the earliest case reports of ectopic pregnancy were written up in the 16th century, in every single case, the mother had died from the ectopic pregnancy rupturing. It was considered a universally fatal complication.
The first surgical treatment of an ectopic pregnancy took place in the early 19th century: the mother survived the hysterectomy, which removed the ectopic pregnancy along with her ovaries, uterus and tubes. It proved the principle that ectopic pregnancy could be treated.
But there were two big challenges still to overcome: surgical hygiene, and diagnosing ectopic pregnancy before it ruptured. In the 19th century, medical science wasn't very good at either, and the mortality rate was about 90%.
In 1884, surgeon Robert Tait publicised an effective surgical technique for tubal ectopic pregnancies: salpingectomy. This surgery involves removing the tube and the ectopic pregnancy. He himself performed thousands of the procedure, and salpingectomy is still performed today.
By 1920, the mortality rate for ectopic pregnancy had dropped to around 12%, and by 1947, it was below 3%. Surgery had become the go-to approach for treatment.
However, accurately diagnosing ectopic pregnancy remained a problem. There was a high rate of false positives and false negatives. In the 1940s, around 20% of surgeries for a diagnosed ectopic pregnancy turned out to not be ectopic pregnancy on operation, and the same was true in reverse.
It took advances in hormone testing and using imaging techniques such as ultrasound to allow us to diagnose ectopic pregnancy before a risk of rupture.
However, we still have a long way to go in adequately treating ectopic pregnancy. Many families affected by it feel very unsupported and unseen in the emotional side of ectopic pregnancy. Emotions can be complex as a lot has happened: the loss of a pregnancy, concerns about future fertility, trauma following surviving an emergency.
If you're affected by ectopic pregnancy, the Ectopic Pregnancy Trust provide information and support https://ectopic.org.uk/
@vagina_museum
(This reminded me of one of the Twttr journalists I used to follow. So I googled her and she's on LinkedIn.)
(I followed a modest number of people on the bitdsite - professors, practitioners, activists - who posted about the current state and history of reproductive health care ... not just the Vagina Museum.)
Keep dark age republicans and the Spanish Inquistion out of office. All offices, vote, defeat, expunge from office.
But be nice, maybe some sweet tea.
Vagina Museum
Grumpy Penguin 🇦🇺 🇮🇱 🕯️
John Meadows
quangobaud
Kevin Russell
Coles Street Pothole