Suze Lopez simply thought she would resolve a known health problem and get her life back on track. An emergency room nurse, she had lived for years with a slowly growing ovarian cyst. and which logically had to be removed. But when she goes to Cedars-Sinai hospital in Los Angeles to finally schedule her ablation, nothing prepares her for the shock that awaits her.
A banal operation that turns into the unimaginable
Because a few days before the operation, the protocol requires a pregnancy test which comes back… positive!
“Impossible,” she thinks. “Because of the size of the cyst, I initially thought it was a false positive, or even ovarian cancer,” she will recount later. Especially since Suze and her husband spent 17 years trying to have a second child, without success. And yet, a few days later, violent abdominal pain led her to the emergency room. The imaging tests will amaze doctors.
A baby yes… But not in the womb
The images are clear: Suze is pregnant, but her uterus is empty.
“A giant benign ovarian cyst weighing more than 9 kilos took up considerable space in the abdomen, and behind it was an almost full-term baby,” explains Dr. John Ozimek, medical director of the obstetrics department.
The fetus developed in the abdominal cavity, near the liver. An extremely rare situation called abdominal ectopic pregnancy. Or ectopic pregnancy.
How can an embryo lodge in the liver?
The question is intriguing, even astonishing. How can an embryo survive outside the uterus, and even more so, near an organ like the liver?
Dr Jonas Benguigui, obstetrician-gynecologist, provided essential insight into a previous case:
“Instead of following the normal path towards the uterus, the embryo can be drawn into the mixing of peritoneal fluid and end up in the belly. The liver, which is highly vascularized, then becomes a suitable site for implantation.”
In the vast majority of ectopic pregnancies (97%), the embryo remains stuck in a fallopian tube. But in very rare cases, the fertilized egg attaches itself in the abdominal cavity.
A pregnancy that puts the mother’s life in danger
Although this nesting site sometimes allows the fetus to survive for a while, it represents a vital danger for the mother. “The liver is a very vascularized organ. In the event of a rupture, the patient can bleed out in a few minutes” alerts Dr. Benguigui.
Beyond 14 weeks, the risks become major:
- Massive internal bleeding;
- Rupture of the organ;
- Maternal death.
This is why this type of pregnancy is generally not viable. “The only possible treatment is surgical, often with partial removal of the liver”specified our expert.
In Suze’s case, events decided otherwise.
“In France or the United States, ectopic pregnancies are generally detected very early thanks to beta-HCG measurements and early ultrasounds. We can then offer medical treatment with methotrexate” emphasized Dr. Benguigui. Yes, but that was without taking into account the giant ovarian cyst which completely made the fetus invisible, until the pain became unbearable.
An extraordinary intervention… and a miracle baby
Faced with this exceptional situation, around thirty health professionals are mobilized. The intervention is a real race against time: deliver the baby, remove the 10 kg tumor and save the mother.
Birth remains very sensitive. Suze Lopez suffers severe hemorrhage. “We used 11 units of blood. Every second counted”says Dr. Michael Manuel, gynecological oncologist in the hospital press release.
But against all odds, the baby, named Ryu, is born healthy.
It weighs 3.6 kg and has very few complications. “He defied all predictions,” summarize the stunned doctors.
An absolute medical rarity
Intrahepatic pregnancies are among the rarest in the world. Isolated cases have been reported in China (2017), in France (1999), and barely twenty in total in fifty years. Most never reach the second trimester.
This birth, carried to an almost complete term, is therefore an absolute exception. For Suze and her husband, there is no doubt: Ryu is their Christmas miracle baby. A gift also for the doctors, for whom this case will long remain engraved as one of the most incredible medical challenges of their career.