Huang Yijun, 92
Have you ever thought to yourself, “Wow, nine months of pregnancy is a long time…” or known women who are in their last trimester and so excited to have their baby and not be pregnant anymore? Well imagine being pregnant for 60 years. While watching TLC, I saw a curious case of a 92-year old woman delivering a baby that she had been pregnant with for 60 years. They called the fetus a “stone baby”.
A “stone baby” is really called a lithopedion. A lithopedion is a rare phenomenon in which a fetus dies during an abdominal (or ectopic pregnancy). In very rare cases, an egg will be fertilized in the fallopian tubes but implant in the abdomen or bowels. This can be dangerous, especially to the mother, but the pregnancy can be maintained and the fetus will continue to grow and develop. But with a lithopedion, the fetus dies and then cannot be reabsorbed by the body (some “stone babies” have been found to weigh 9 pounds and be fully developed) and so the amniotic sac calcifies. This occurs to protect the mother from infection caused by the decomposing tissue of the fetus and for some reason, the body does not identify the calcified mass as foreign and can remain as is.
Huang Yijun, 92, was the mother of the most recent publicized “stone baby” in 2009. She was from southern China and claimed that she could not afford to have the fetus removed after she was told it had died inside of her. This is the case with many other citations of stone babies; the mother could not afford medical care or did not have obstetric care readily available to them.
Overall, stone babies are very rare and only about 290 cases of lithopedion have ever been recorded (Bondeson 1996). The earliest known case was in 1582 in which a stone baby was found during an autopsy of a woman. This phenomenon of stone babies is so fascinating because it yields yet another example of the curious ways in which the human body can work and almost seems unreal and mythological in our time of available healthcare and medical standards.
Bondeson, J. "The Earliest Known Case of Lithopaedion." Journal of the Royal Society of Medicine 89.1 (1996). Print.
Mapes, Diane. "Body Odd- The Curious Case of the Stone Baby." Msnbc.com. May 2009. Web.
I found another interesting case study of lithopedion formation. The findings of Jain and Eckert were published in 2000. A 38-year old woman showed symptoms of abdominal pain, fever, and chill for close to 5 days. When her past medical history was looked at, it was found that the woman had had an abdominal pregnancy 2 years earlier. Abdominal pregnancies are rare and only occur in 1 out of every 3,372 to 7,931 pregnancies. Fetal mortality is high in these cases and there is up to an 18% maternal mortality rate for abdominal pregnancies.
ReplyDeleteAt week 16 of pregnancy, the subject’s abdominal pregnancy was diagnosed. The patient refused to have surgery to remove the fetus so a potassium chloride injection was administered to abort the pregnancy. However, the fetus was not reabsorbed into the body. Due to the calcified remains of the fetus, the subject had received a pelvic abscess. This is the first documented case of a lithopedion leading to pelvic abscess. In other cases failure to remove abdominal pregnancies and lithopediion formation have included intestinal obstruction, fistula formation and cephalopelvic disproportion.
What I found interesting about this case study is that the hCG levels were measured in the subject 2 weeks after the potassium chloride injection. The levels had returned to normal, showing the body had believed that the baby was aborted. However, this was clearly not the case. My question is what causes the body to be unable to reabsorb the fetus and why does it not recognize the solidified fetus as a foreign object?
References:
Jain, T. and Eckert, L. O. (2000). Abdominal Pregnancy with Lithopedion Formation Presenting as a Pelvic Abscess. Obstetrics & Gynecology. 96(5, Part 2): 808-810.
This topic was surprising to me, as I have heard of ectopic pregnancies and learned of the various types based on location, such as cervical, interstitial, isthmic tubal, intramural, ovarian, intraligamentous, ampullar tubal, infundibular tubal, and abdominal. However, I've never heard of anything such as lithopedion occuring. I researched the topic a bit more and found an article which documented a 40-year old Tanzanian woman who had a live intraabdominal pregnancy (at 15 weeks of gestation) with a concurrent lithopedion of advanced gestation (over 2 years gestation). The woman, prior to this, had had 6 uncomplicated pregnancies which were carried to term and delivered normally.
ReplyDeleteThe idea that the woman could have two abdominal ectopic pregnancies, one being lithopedion, surprised me even more, considering the rarity of abdominal ectopic pregnancies themselves (above, Ashley listed the occurrence at 1 out of every 3,372 to 7,931 pregnancies). The fact that this patient presented with two abdominal pregnancies out of 8, and at the same time, is incredibly statistically rare.
Massinde A, Rumanyika R, Beatrice H. Coexistent Lithopedion and Live Abdominal Ectopic Pregnancy. Obstetrics & Gynecology [serial online]. August 2, 2009;114(2):458-460. Available from: Academic Search Premier, Ipswich, MA. Accessed November 22, 2011.