Simply Lambchops: July 2017

Ectopic pregnancy - A close shave with death

Pregnancy Friday, July 14, 2017

On that eventful day in May 2004, the day started as usual for me. I had been experiencing constant abdominal pains for about 2 weeks and sometimes, diarrhoea and bloatedness too. A General Practitioner diagnosed these symptoms as heartburn and/or gastric pains and prescribed a course of medicines for me. Despite the pains, I went to work as I needed to prepare materials required for my students' Science practical exam.

The abdominal pains increased in intensity within the next few hours after I reached school - to the extent of a very bad gastric pain but by many folds more. I ate the meds but it didn't ease the pain. Worried, my colleagues advised me to rest at the sick bay and got Hubby to drive me home. I had wanted to go home and rest, hoping to sleep it off, but Hubby insisted on swinging by our usual family doctor for a check.

My family doc gave me a jab to accelerate the relief of the "gastric pains" but her experience and instinct told her to look out for other risks - I had told her that I was pregnant but the gynae couldn't see an egg sac despite a positive urine test. After 15 minutes of waiting at her clinic and seeing that I was going into distress with the intense pains, she instructed Hubby to send me to KKH A&E immediately.

Things happened very fast after reaching KK Hospital. I had lost all my strength while bearing the pains and collapsed on a wheelchair. An ultrasound scan later, I was briefed by a gynae at the A&E that my abdominal cavity was filled with fluid and she needed to perform a laparoscopy immediately to investigate the cause.

Ectopic pregnancy

According to a Straits Times report in 2011, an ectopic pregnancy occurs in 1 in 300 pregnancies. (link to report) In the UK, it affects 1 in 80 pregnancies. (link)

Ectopic pregnancy is a leading cause of mortality in pregnant women. Basically, it is a pregnancy where the fertilised egg is located outside the uterus (womb) and the most common site is within the fallopian tube. A small number of ectopic pregnancies occur in the ovary, cervix or abdominal areas. An untreated ectopic pregnancy can be fatal as the internal organ can rupture if stretched too much by the growing pregnancy. This can cause rapid bleeding, infection, or lead to death. With prompt treatment, complications can be reduced and the chances of conceiving again are increased.

photo source

In my case, the fertilised egg was found on the external surface of my intestines and I was told by that gynae that this is one of the rarest forms of ectopic pregnancies. According to this source written in 2013, cases like mine account for only 1.4% of ectopic pregnancies. That also caused the "gastric pains" and excessive internal bleeding. My foetus was removed and my abdominal cavity was cleaned up. In my delirious state after the surgery, I heard there were also stitches done to repair the wound on my intestine.

Photo from laparoscopy (May 2004)

Based on the features of the little bean (see his eye and undeveloped limbs?), the gynae estimated that he was around 2 months old. ("he" as a generic pronoun.)

That makes one wonder, how on earth did he get there??

What are the symptoms of an ectopic pregnancy?

Symptoms of ectopic pregnancies may occur from as early as 4 weeks after conceiving and up to 12 weeks or later. According to KK Women's and Children's Hospital, if a woman has an ectopic pregnancy, she may:

have missed her period
notice pregnancy symptoms like breast tenderness and nausea
have irregular vaginal bleeding, known as spotting
feel lower abdominal or pelvic pain on one or both sides that grows worse over time

If the ectopic pregnancy ruptures, she may:

feel severe pain in her lower belly
develop shoulder pain triggered by internal bleeding
feel dizzy and notice a whirling sensation
faint or pass out

Consult your gynaecologist early if you notice these symptoms.

*****

It is 13 years since the ectopic pregnancy and God has blessed me with three more beautiful children. As we celebrate their birthdays in the next three months, I also remember my first bean who did not get the chance to enjoy our family love. I don't really miss him because the episode was too traumatic for me to get emotional over the loss, but his short stay in my body taught me some lessons.

If I had gone home to rest as what I intended to do ...

If Hubby had not insisted on sending me to my family doctor ...

If the family doctor had not kept me at her clinic for observations ...

If we had not been attended by that experienced doctor at KKH ...

... I might have bled to death that day.

The close shave with death was not a mere coincidence of events or luck. It was a striking reminder that God has blessed me over and over again and that my work on earth was not yet over. I am thankful for His faithfulness because He has promised that He will never forsake us in every situation we have to face.

For He Himself has said, "I will never leave you nor forsake you." Hebrews 13:5 (NKJV)

Sometimes when I am so wrapped up in my frustrations, I lose sight of Him. I forget His greatness and how He has always delivered me out of life's challenges. But the good news is, when I humble myself to lean on Him again, I feel His presence and realises that He has always walked close to me.

And peace fills my heart.

(You may also want to read about my guest contributor's (Faith Liu) after-birth experience and why she thinks maternity insurance is important.)

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Maternity Insurance - Do you really need it?

guest post Monday, July 10, 2017

Guest contributor

Faith Liu

My son Aiden was born in 2007. He was distressed during the birth process and pooped in the water bag. Therefore he spent the first few days of his life in an oxygen box in the Neonatal Intensive Care Unit, with a tube sticking out of his little arm. He was a fretful baby in the beginning and cried a lot. I attributed it to not being able spend much time in close proximity with him in the early few days. We stayed in the hospital longer than we expected. Although he was healthy in the womb, the hospital bill was thousands of dollars more than anticipated because of the intensive care he had to receive.

All parents wish for their children to be born healthy and whole. My experience is an example that even when your baby is healthy while in the womb, complications could occur during childbirth. Depending on the severity of the complication, it could seriously impact the cash flow of your newly expanded family. Furthermore, certain birth defects like sickle cell anaemia, a malformed kidney or cystic fibrosis may take a longer time to be detected. Not many of us parents realize that congenital defects in newborns are not actually rare.

In a study done in Singapore from 1994 to 2000 by KK Women’s and Children’s Hospital, for every 100 live births, 2.39 were with birth defects.

When a child is born with birth defects or congenital diseases, it may severely impact his or her healthcare costs in future.

In terms of risk transfer, what can parents-to-be do to ensure that if ever their child needs costly medical treatment, the funds would be available? There are a number of insurers who provide pre-natal protection for mother and unborn baby as early as 13 weeks into the pregnancy. Typically, it covers pregnancy complications and extended hospital stays for both mother and child due to the complication. Certain plans provide a lump sum payout of between $5,000 to $12,000 for a list of pregnancy complications or congenital illnesses. Others provide coverage for twins and also babies conceived through in-vitro-fertilisation.

What is most attractive about these pre-natal insurance plans is that there is an option to transfer the insurance coverage from mother to baby, without further medical underwriting. This would mean that if the mother had a plan in place, she could transfer the coverage under the plan to her child, even when there is a birth defect or congenital diseases. This is significant because if a child has a congenital disease, it may prove very difficult if not impossible to take up future insurance coverage. As with all insurance plans, it is recommended that the policy be taken up as soon as you are eligible before any possible complications arise. The prospective mother may find that the coverage is not available to (or exclusions of coverage imposed on) her and the baby if she is, for example, found to have gestational diabetes, or if the baby is detected to have birth defects while in the womb.

New parents often have fun shopping for the new décor for the baby’s room or nice outfit for a baby girl. I strongly urge you to consider adding insurance protection planning for your child into the list of to-dos.

About Faith

Faith is a financial services consultant with AIA Singapore Pte Ltd. She is trained as a civil engineer and taught in a secondary school for 14 years before she was headhunted to join AIA. Her two lovely children are her pride and joy, Aiden aged 10 and Kathryn aged 6. Faith can be reached at faith_liu@aia.com.sg

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