BEYOND THE WOMB: A STORY OF LOSS AND SURVIVAL

December 11, 2025

A Story: The Pain That Came Between Ordinary Days

A 28 year old female ,married for a couple of years and a mother of two energetic children. Her eldest was six year old, and her youngest, baby was just 11 months old—still wobbling with each new step she took, giggling as she tried to keep up with her big brother.

Life was busy and joyful and exhausting in all the usual ways. Between school drop-offs, late-night feedings, and juggling house-hold tasks, she rarely thought about herself. So when her period came late, she blamed it on stress, sleep deprivation, and the chaos of motherhood.

Five Days Earlier: What she ignored

It started with a dull ache in her lower abdomen—slightly stronger than usual, but nothing alarming. assuming her cycle was just being unpredictable again, the way it often was since having her second child .The bleeding continued through the day, not heavy, not light—just enough to convince her it was menstruation.

The Morning It Became Impossible to Ignore

On the 5^th day of morning, the abdominal pain came in waves. It wasn’t normal, but she brushed it off initially and within an hour she experienced a sudden, stabbing pain shot through her left lower abdomen.

Day 5: When She Finally Sought Help

As the pain grew so intense that she could barely finish house hold works. Her abdomen throbbed, and waves of nausea came and went.

Visit to Nearby Clinic (Initial Management)

Symptomatic pain management treatment given and kept her for observation ,after few hours patient BP fallen down , Refer to higher centre.

Arrival at Emergency Department

At the Emergency Room :

Patient looks pale, drowsy , and in severe diffused abdomen pain.
Vitals: BP 70/30 mmHg, Pulse 160/min ,RR 30/min, GCS – E3 V4 M6 ,GRBS – 531mg/dl

Examination :

Abdomen: Marked diffuse tenderness present with more prominent in the left iliac fossa with guarding and distension of abdomen.
CNS examination : Drowsy , obeys verbal commands.

Investigation at Emergency Room :

Urine pregnancy test: Strongly positive
ABG : pH – 7.15 , pCO2 – 42.7 , HCO3 – 13.4 , Hb – 6.3 , Glucose – 531 mg/dl
Serum β-hCG: 4786 IU/L
USG abdomen and pelvis :
Gross ascites with internal echoes
Ill defined heterogenous lesion in left adnexa and pelvis – likely hematoma.
Small heterogeneous left adnexa cyst

Diagnosis

The findings were consistent with a Left tubal ectopic pregnancy, with rupture.

She asked softly, “So… does this mean I’m losing the pregnancy?” Then we reassured her that it wasn’t her fault and that they had caught it before it became life-threatening . We will be removing the affected left fallopian tube through tiny keyhole incision under anaesthesia , and you can still conceive normally with your healthy remaining tube.

Management

Emergency Care

IV fluids, oxygen given , Blood Transfusion
Pain management

Definitive Management

Due to hemodynamic instability, she was immediately taken for laparoscopic left salpingectomy.
Around 1200mL of hemoperitoneum noted.

Outcome

She recovered well post-operatively . She asked about her future fertility, and the gynecologist explained that many women conceive normally with one fallopian tube. She was referred for follow-up and emotional support.

She left the hospital two days later, grateful for the care she received and relieved that she had sought help when she did.

Discharged with advice on : Early scanning in future pregnancies , Recognizing warning symptoms