Suze Lopez, a 41-year-old nurse from Bakersfield, California, learned she was pregnant only days before a scheduled operation to remove a 22-lb ovarian mass she had lived with for years. The pregnancy test was part of routine pre-operative screening for the planned cystectomy. Lopez had irregular periods and abdominal discomfort due to the tumor.
A few days after learning she was pregnant, she developed abdominal pain and went to Cedars-Sinai Medical Center in Los Angeles, where physicians discovered that the fetus was not in the uterus but was developing in the abdominal cavity, an extremely rare form of ectopic pregnancy often described as an abdominal ectopic. The baby was located near organs including the liver and was effectively concealed by the large ovarian tumor.
A multidisciplinary team of roughly 30 specialists, maternal-fetal medicine, gynecologic oncology, anesthesiology and neonatal specialists performed an operation that both delivered the baby and removed the 22-lb ovarian mass. The bleeding was controlled, 11 units were infused. Hospital statements described the outcome as a “medical miracle.” Both mother and baby were reported to be doing well in follow-ups, the infant “Ryu” had an approximate birth weight of eight pounds.
The incident sparked genuine surprise in the medical community since ectopic pregnancies, delivering in full term is quite rare.
An ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity; the most common site is the fallopian tube. In rare cases the embryo implants in the abdominal cavity (peritoneal cavity), called an abdominal ectopic pregnancy, which accounts for a very small fraction of ectopic pregnancies and carries high maternal risk because of potential major haemorrhage and placenta attachment to abdominal organs. These pregnancies are usually detected early by ultrasound and hCG monitoring, but they can be missed or masked by other abdominal conditions. In this case, the 22-lb ovarian tumor obscured the pregnancy on routine assessment and concealed typical signs.
Medical literature notes that abdominal ectopic pregnancies can implant on structures such as the omentum, peritoneum, liver surface, or other organs; diagnosis and management are complex and require experienced, multidisciplinary surgical teams because of the risk of massive bleeding and coagulopathy if the placenta separates from an abdominal organ.
Abdominal ectopic pregnancies are rare but serious. They can present with non-specific symptoms such as abdominal pain and bleeding or, in late cases, with acute haemorrhage if the implantation site ruptures. Because the placenta in an abdominal pregnancy may adhere to organs with large blood supplies (for example, the liver or large vessels), delivery is surgically challenging and carries a substantial risk of maternal blood loss and coagulopathy. Neonatal outcomes vary with gestational age and the complications of the implantation site.
Cedars Sinai press release on dec 10th, indicates the ovarian lesion measured large enough to weigh approximately 22 pounds (around 10 kilograms). Large ovarian cysts and tumors can cause irregular bleeding, abdominal distension and discomfort; they are typically evaluated with imaging (ultrasound, CT or MRI) and surgical planning. For this patient, the team performed a combined procedure: prompt delivery of the fetus followed by removal of the ovarian mass, with appropriate neonatal and maternal support on standby. Careful intraoperative planning and collaboration across specialties to minimise bleeding and ensure neonatal resuscitation capacity were also done.
Lopez told reporters she had experienced irregular periods and intermittent abdominal discomfort for years due to the tumor and had tried for a second child for many years. She said she was “in disbelief” on learning she was pregnant since it could have been a false positive due to the tumor.
Standard guidance for suspected ectopic pregnancy includes serum hCG measurement, transvaginal ultrasound imaging, and prompt referral to specialist care if an extra-uterine pregnancy is suspected. Management options depend on stability, gestational progress and location; they range from medical therapy for early tubal ectopics (e.g., methotrexate) to urgent surgical intervention for unstable presentations or abdominal implantations. For abdominal ectopics diagnosed at advanced gestations, careful surgical planning and neonatal support are critical.
(Rh/TL)