Comments on: Ectopic Pregnancy and Tubal Rupture After Tubal Reversal

By: Dr. Berger

Dr. Berger — Thu, 12 Jan 2012 21:39:41 +0000

Janelle – I am distressed to learn about what happened. I cannot understand why some doctors do not follow our recommendations for early pregnancy monitoring since they can prevent the complication of a possible ruptured tubal pregnancy. You could have an HSG to assess your left tube. If you do have this done in the future, please instruct the radiologist to send your HSG images to us to review. An HSG would have to be ordered by your local physician.

By: Janelle Burgess

Janelle Burgess — Thu, 12 Jan 2012 03:41:15 +0000

I followed your rules perfectly but it doesn’t matter because all of the Physicians I saw had the wrong answers to everything.

My first HCG count was 750. Two days later it was 1500. I started spotting the next day. Was in Vegas and went to the ER. The doctor there sent me for an abdominal ultrasound which showed no baby. Then the vaginal ultrasound showed no baby but my HCG count was 2300. Dr said that the problem is that people go off of the date of a girls last period which I had tracked along with ovulation. She said I may not be the six weeks that the chart said and may only be 4 weeks. She said at 4 wks, the ultrasound machines would not even show a sac. She said the spotting was because of sex which we said we hadn’t had.

Then got home to Oklahoma City and went to the ER because I was in so much pain that I couldn’t do anything but scream and cry. 7 doctors were by my side because they couldn’t keep my blood pressure stable it was 70/40 and I had 3 IVs running. They told me flat out that they thought I was going to die. Since there was only one OBGYN Surgeon on call, we had to wait til she got there. I cried and told the doctors that I didn’t want to die. They said that they understand and would want to go to a different hospital also but they were afraid that I would die on route if I didn’t have the ER care that I needed. They did an abdominal ultrasound and vaginal ultrasound and neither showed a baby. I did have an HCG of 3200. I told them that I must have an ectopic pregnancy. I asked for the drug that aborts the baby and they laughed and said that is not possible with tubal pregnancies. They said, once the baby attaches to the tube that the tube must be removed. I’m certain they are wrong. They finally decided to believe because of my blood pressure and they were giving me enough morphine to take down an elephant and I was still screaming and I mean SCREAMING.

Well, the OBGYN showed up 6 hours later. She tried to get me to sign a consent for a hysterectomy which I refused. Then she tried to get me to sign a consent to remove one ovary and the tube if needed. I refused on the ovary. I was rushed into surgery and the surgeon removed my right fallopian tube. I was given a c-section type surgery and am still in recovery. (btw she butchered my beautiful scar line that Dr. Berger did) It’s been 6 wks. So how can this be prevented again? It can’t.

I couldn’t find an OBGYN that would agree to see patients before 10 weeks. They said it is because of the high risk of miscarriages. Instead of waiting, I decided to go to a family urgent care clinic for my counts.

The only thing I can say is be prepared for the worst and hope for the best. I can tell you that I am now having some type of panic problems. I keep reliving the pain and horrible experience over and over again. I have a hard time trying to forget what happened. The pain of an ectopic pregnancy is indescribable. I’m not trying to scare you. I only want you to find a way to prepare yourself.

If the doctor does not see the baby, then maybe you may consider aborting. However, if the doctor says that you may only be 4 wks when your chart says 6 wks, and they can’t see the baby, you may need to get another ultrasound quick.

Just one more thing. Yes, I know I can probably get pregnant on the left side but now my chances are only every other month which is now going to take twice as long. Plus, I’m so scared about having the same thing happen again but I really want a baby.

My understanding is that my baby got caught in the scar tissue of the right fallopian tube. Is there not a way to prevent scar tissue on the tube? Or better yet, is there a test to see if I have scar tissue covering my left tube?

By: Dr. Berger

Dr. Berger — Mon, 28 Nov 2011 17:30:22 +0000

Jenny – There is no arbitrary period that you need to wait after tubal reversal to reduce the chances of an ectopic pregnancy.

By: Jenny

Jenny — Mon, 28 Nov 2011 16:53:56 +0000

Is there a time frame to wait after having a tubal reversal to become pregnant to reduce the chances of an ectopic pregnancy?

By: Charles Monteith MD

Charles Monteith MD — Sun, 26 Sep 2010 17:16:23 +0000

Alicia You should have a HSG x-ray to evaluate your tubes. Your reversal doctor will have to discuss the results with you.

By: Alicia Pop

Alicia Pop — Sun, 26 Sep 2010 15:33:39 +0000

I am worried I had a tubal reversal in 2009 and I have had two ectopic pregnancy I am 36 and I so want to have another baby. My first was on my left side and the last was on my right side. Dose this mean both sides are blocked? The doctor that did my surgery is no help I am looking for answers please help me.

By: Charles Monteith MD

Charles Monteith MD — Mon, 13 Sep 2010 02:05:49 +0000

Tammy
Any pregnancy after tubal ligation is concerning for an abnormal opening in the tube. This can lead to an ectopic pregnancy. If you were every to have another positive pregnancy test again then you should see a medical professional right away. It is possible this can reoccur.

By: Tammy

Tammy — Mon, 13 Sep 2010 02:01:50 +0000

I had my TL done in 1996 when I was just barely 26yrs old, and my doctor NEVER told me about all of the horrible things that can come from this procedure…and to make matters even worse when I went back 2 weeks later for severe pain in my side, he had FORGOTTEN he had done the tubal ligation and thought I was there for a post delivery check up. I had these pains for 13 years..been in and out of the dr’s office and the ER’s only being told “surgical adhesions” were the cause of my problems. Then about 4 months ago, the pains stopped. Last month I started gaining weight, was exhausted, my ankles kept swelling, then nausea. I didn’t think it was possible, but the pregnancy test was positive…which my dr thinks was a chemical pregnancy. Can this happen again or is this just a fluke that won’t ever happen again?

By: First Pregnancy After Ligation Reversal: Georgia Peach is Pregnant!

First Pregnancy After Ligation Reversal: Georgia Peach is Pregnant! — Thu, 22 Apr 2010 13:25:41 +0000

[...] but we were also very aware the likelihood of it being a miscarriage – or even worse an ectopic pregnancy.Pregnancy Risks After Tubal Reversal After work, I went to the ER and we spent all of New Years Eve [...]

By: Pregnancy After Ligation Reversal: Georgia Peach Has a Pregnancy Loss

Pregnancy After Ligation Reversal: Georgia Peach Has a Pregnancy Loss — Tue, 06 Apr 2010 23:17:57 +0000

[...] couldn’t promise. He gave us some instructions and paperwork and we were sent to the hospital.Ectopic Pregnancy After Tubal Reversal.We arrived at the hospital and were rushed through admissions, and into the [...]

By: Dr. Berger

Dr. Berger — Mon, 22 Feb 2010 21:58:40 +0000

Jennifer – Your information indicates that you had a ruptured tubal pregnancy. With scarring of your fallopian tubes, IVF would be the best option if you want to become pregnant again.

By: Jennifer

Jennifer — Mon, 22 Feb 2010 21:51:42 +0000

I recently found out I was pregnant. At five weeks/5 days I had an ultrasound. They did not see a sac in the uterus but saw fluid around the uterus. My hcg level was falling and I was rushed in for surgery and they found that there was a hole in one of my tubes and my abdomen was full of blood. They washed me out and saved the tube. The doctor told me after the surgery that I had a lot of scarring in my tubes and she thought that if I tried to get pregnant again that it would result in a tubal pregnancy. What should I do? Should I just forget about getting pregnant?

By: Charles Monteith MD

Charles Monteith MD — Tue, 17 Nov 2009 13:23:14 +0000

Kay
Any pregnant woman in the first trimester with severe pelvic pain should be evaluated for an ectopic pregnancy.

By: Kay

Kay — Tue, 17 Nov 2009 12:31:31 +0000

My husband and I are trying to have a child and I’ve successfully gotten pregnant. However, at this time we don’t have the health insurance needed for me to get an ultra sound to see how far along I am. We’ll have the insurance in January, but for now I’m taking extra good care of myself for my child’s sake. However, I have a pain and soreness where my right ovary should be and it’s swollen and stiff to the touch. I’m scared it could be an ectopic pregnancy… I can’t have an ultra sound yet to know for sure, and I’m scared. There’s no history of this happening in my family, and I don’t know what to think. I’m not having any other symptoms. Just the soreness and swelling. I also suffer from the occasional painful ovarian cyst, but I don’t know…

By: Charles Monteith MD

Charles Monteith MD — Wed, 14 Oct 2009 14:24:21 +0000

Smoking and age do not increase the risk of ectopic pregnancy. The risk of ectopic pregnancy are increased by anything which changes the natural function of the fallopian tubes, namely pelvic infection and pelvic surgery.

It is possible to have IVF as long as you have a uterus. Even if both fallopian tubes are removed then IVF can be done. IVF does have risks. Anyone considering IVF should read our blog: Tubal Reversal After 40: IVF Risks .

By: maria magdalena

maria magdalena — Wed, 14 Oct 2009 14:12:21 +0000

Two more questions:
Does smoking or age increase the risk of ectopic pregnancy?
If an ectopic pregnancy does occur and the fallopian tubes have to be removed is still possible to have IVF?

By: Charles Monteith MD

Charles Monteith MD — Wed, 14 Oct 2009 13:58:09 +0000

Maria The risk of ectopic pregnancy in the general population is 1-3%. The risk of ectopic pregnancy among women who have IVF is 1-3%. The risk of ectopic pregnancy among women with tubal reversal is 10-15%. There is nothing that can be done to change the risk of ectopic pregnancy. We do recommend monitoring early pregnancies and if they are ectopic then ending the pregnancy with a medication called methotrexate, which can avoid the most serious problems with an ectopic pregnancy.

By: maria magdalena

maria magdalena — Wed, 14 Oct 2009 13:43:01 +0000

My question is: what is the risk of ectopic pregnancy in the general population and what is the risk in women with tubal reversal. Is there anything that can increase or decrease the risk of ectopic pregnancy after tubal reversal? Thank you very much.

By: Jessica

Jessica — Fri, 29 May 2009 02:09:09 +0000

I had a tubal ligation in 2001, my husband and I decided we wanted to have another child and I went through the tubal reversal surgery. We became pregnant four months after having the surgury done. We had a healthy baby boy. Now 2 years later we opted to try for another one. I became pregnant and had an etopic pregnancy that was terminated at 4 weeks, my left tube was removed. What would cause our 1st pregnancy to be normal and this second one to be etopic? I am still left with my right tube but question whether we should even bother trying for another child at this point. My doctor suggested having a dye (HSG) test done prior to me trying to become pregnant. Is this the only method to determine if my tube is open or not and if I am at a higher risk for another etopic pregnancy?

By: Dr. Berger

Dr. Berger — Wed, 22 Apr 2009 11:31:10 +0000

If the pregnancy is in your tube, rather than having been in your uterus, of course there is the risk of tubal rupture. Your doctor should know whether the pregnancy was in the uterus or not. If you are not confident about the doctor who has been treating you, then you should consult with another ob/gyn physician.

By: linda

linda — Wed, 22 Apr 2009 08:20:51 +0000

I had an abortion a month ago. I might be 3 weeks pregnant right now and I started having lower back pain as well as sharp abdominal pains on the lower left side for about a week now. I’m scarred that it is an ectopic pregnancy but because it is possible for the pregnancy hormone level to be the cause of my positive pregnancy tests and the dr. was not able to see anything in the uterus with the ultrasound, I’m not getting treatment. Is there anything else that can be done besides waiting? Can my tube rupture at this point (3-4 wks)

By: Charles Monteith MD

Charles Monteith MD — Tue, 07 Apr 2009 13:38:02 +0000

You did have the recommended treatment. The injections of methotrexate generally will treat an ectopic pregnancy but the medication is not always 100% effective. Most people will not have a tubal rupture after methotrexate and will be able to save their tubes. Sounds like your doctors followed our protocol but you were one of the few patients who did not have success with the methotrexate treatment.

By: Francine Fortune

Francine Fortune — Tue, 07 Apr 2009 13:21:16 +0000

I had a tubal pregnancy in my right tube about two months ago…I had the injections and the doctors watched my levels for about two weeks. Then all of a sudden when my levels were down to 2000 I had a sharp pain in my right side and started to pass out and get very weak. I was rushed to the hospital to be told that my tube had ruptured and I had 1 litre of blood in the abdominal area….I had emergency surgery and I am still recovering….My question is, could this have been prevented if they had to do the surgery to begin with or even after it took two weeks to get my levels to come down? When is the maximum amount of time doctors wait before they opt to do the surgery to prevent a rupture. I lost my right tube and I also have damage to my left tube. Luckily I have two kids already but would like to have one more….

By: Anonymous

Anonymous — Tue, 31 Mar 2009 19:25:20 +0000

I am in need of advice….I had a tubal pregnancy back in 2004 and was told I lost everything on my left side, so with that I decided to tie my right tube. My Husband and I really regretted doing this, so we decided to go through IVF last October. Sad to say it didn’t take. I then went to another doctor had surgery to see about getting my one tube untied. Come to find out I still have everything on my left side and could have reconstructive surgery and untie the other tube. My insurance paid for the in vitro, but will not pay for this surgery. I fear I will have another ectopic pregnancy and loose a tube and be out thousands of dollars.

By: Dr. Berger

Dr. Berger — Sun, 11 Jan 2009 02:00:41 +0000

Lisa Marie -

Hopefully your HCG level was over 1500-2000 when you had the ultrasound. It has to be higher than that for a vaginal ultrasound exam to see a gestation sac in the uterus. When a gestation sac is not seen and when the serum HCG level is high enough, the possibilities are either a “blighted ovum” that is in the uterus but will miscarry, or a pregnancy outside of the uterus (ectopic pregnancy).

By: Lisa Marie

Lisa Marie — Sun, 11 Jan 2009 00:22:59 +0000

I Just found out i had a tubal pregnancy and was given the shot, so far i’m ok but bummed tht the baby was in the tubes and not the uterus. I followed Dr. Berger’s instructions for early pregancay mointoring and nothing was ever at 6 weeks a baby cound not be detected in my uterus

By: Aurelia

Aurelia — Sat, 08 Nov 2008 03:42:41 +0000

I would like to thank Dr. Bergers office for their support this week after I had a ruptured ectopic pregnancy that lead to the loss of my left tube.

I want to stress the importance to everyone for careful monitoring, I had my AF on Sept 27 and then when it came again on Oct 23, it did not occur to me that I was pregnant. On Nov 1rst, I had extreme pain on the left side, I thought I had a cyst that burst as the pain subsided after 4 or five hours. Nov 2nd I felt okay, tender and bloated, but minor pain. Nov 3rd, in the afternoon, the pain came back, my abdomen started to swell, I went to the ER, had three sonograms and after 7 hours, was told “Congratulations, your blood test shows your pregnant”, and you most likely had a cyst that burst, go home and take it easy and follow up with your OB the next day. By the time I got to my doctor the following night, I could barely sit. My Dr. took a transvaginal ultrasound and immediately confirmed a ruptured left tube and my abdomen was full of blood. I was in surgery within an hour and am so grateful to my doctor.

By: Dr. Berger

Dr. Berger — Thu, 18 Sep 2008 23:06:42 +0000

Brittney -

It is disturbing that ruptured tubal pregnancy was allowed to occur, since it is preventable by following the protocol described in this blog article. Serum HCG assays and ultrasound are available in any community and should be used appropriately by doctors caring for women early in pregnancy.

By: brittney lee

brittney lee — Thu, 18 Sep 2008 22:55:37 +0000

I had a ruptured tubal pregnancy last thanksgiving. I was 3 months along. i had complications from the very beginning. I asked the doctors over and over if there was any chance that it could have been atubal pregnancy. they checked everything and told me everything was fine. Then the day after thanksgiving I got so sick I had to call my mother to come take me to the hospital. we went to the emergency room. They told me that I was misscarring the baby. they gave me a shot and sent me home. My mother was concerned so she took me to her house. There I kept passing out and vomiting. So she called the hospital THey told her that that was from the shot that they gave me. 9 hours later I couldn’t take the pain any more. My mom decided to take me to another hospital. When we arrived they knew exactly what was wrong. They did a vaginal ultrasound and sure enough it was a ruptured tubal pregnancy. I lost 1800cc of blood and they had to remove my left tube. They said that if I wouldn’t have come in I would have died during the night. I think God everyday and pray that I will someday have a baby.

By: Tubal Reversal » Tubal Reversal Information

Tubal Reversal » Tubal Reversal Information — Sat, 05 Apr 2008 18:29:44 +0000

[...] most significant risk associated with tubal ligation reversal is the long term risk of having an ectopic pregnancy. This risk is increased from approximately 2% of pregnancies in the general population to [...]

By: Eddie

Eddie — Thu, 10 Jan 2008 05:34:26 +0000

Yes, I must agree with all that has been stated here. It is very rare to find one surgeon this committed to his patients and their outcome. The relationship Dr. Berger shares with each and ever patient is sincere and true. He will strive for the best outcome, and he requires that of his staff. No one will give better insihgt about this procedure and how the procedure works. Know that all concerns in relation to the tubal reversal are his top priority. His study and information provided on the website is very helpful, and they are reflections of how much he cares about the outcome of every procedure he does.

By: Brandon

Brandon — Wed, 09 Jan 2008 13:23:26 +0000

I think this also brings up a good point about patient doctor relationships. It is important for the patient to be well informed and to do so they must ask questions if something is not quite clear. This also takes a doctor who is willing to address any concerns of the patient. That is why I think Chapel Hill Tubal Reversal Center is unique in that it is made up of an entire staff dedicated to patient care and follow-up.

By: Jennifer Okun RN

Jennifer Okun RN — Tue, 08 Jan 2008 14:44:47 +0000

Many of the patients I schedule for reversal surgery have already had an ectopic pregnancy prior to having any surgery on their fallopian tubes! I have talked with a few women that have had all of their children with only one fallopian tube. A lot of people think a women needs both fallopian tubes in order to conceive, but they only need one. It is also encouraging to see most of our patients that have had an ectopic pregnancy go on to have a normal pregnancy and often more than one normal pregnancy.

By: Ericka Pamplin

Ericka Pamplin — Mon, 07 Jan 2008 19:28:22 +0000

I’d have to agree with both Julia and Rhonda. Nothing is more frustrating or heartbreaking to learn that a patient has experienced a tubal pregnancy. I hope that any patient that has experienced this type of situation, reads this thread and is encouraged by the fact that she can still conceive with one tube!

By: Sarah Meachem RN

Sarah Meachem RN — Mon, 07 Jan 2008 16:30:35 +0000

This story re-emphasizes the importance of following Dr. Berger’s recommended pregnancy protocol after tubal reversal surgery. It is always so upsetting to hear that a patient has lost both a pregnancy and tube and that the loss of the tube could have been prevented. We always encourage patients to take a copy of the pregnancy protocol with them to their appointments and to make sure that they have an OB-Gyn who will comply with Dr. Berger’s recommendations.

By: Julia Smith RN

Julia Smith RN — Mon, 07 Jan 2008 04:31:27 +0000

Patient education is something that Dr. Berger and our entire staff work hard to promote. Nothing is more frustrating or heartbreaking than when we hear that a patient has experienced a tubal pregnancy that has ruptured or required surgery. We hope that the information posted here and on our website – as well as the information given at the time of surgery – will help to reduce or eliminate this situation.

By: Rhonda Brown RN

Rhonda Brown RN — Sun, 06 Jan 2008 21:38:20 +0000

It is reassuring for patients who come to Dr. Berger for tubal reversal surgery to know that he puts the patients safety first. Early pregnancy monitoring is very important since there is a risk for ectopic pregnancy after surgery. We like to be informed of each and every pregnancy following surgery. We also like to be informed of the HCG levels until it is been identified where the pregnancy is. We wish that every pregnancy could be a normal one for all pateints but we have seen patients go on to have a healthy uterine pregnancy following an ectopic. There is hope and early pregnancy monitoring is recommended to help women receive treatment as early as possible. Staff members are available 24/7 not only to answer questions about tubal reversal but also to answer questions about early pregnancy monitoring. This is just one way that Dr. Berger goes above and beyond to help his patients.