It is a decision no expectant mother should ever have to make. But when Paula Cawte was told that her unborn baby was developing outside her womb doctors gave her two heart-breaking options. She could either terminate the pregnancy, or risk her own life to have a baby that would probably be severely disabled - because its birth would have to be so premature - or stillborn. Born survivor: Eva with her proud parents, Paula and Paul Despite the overwhelming odds stacked against her, she risked her life and now her daughter Eva, healthy and thriving, is about to celebrate her first birthday. Her amazing story is even more inspiring considering there are just three recorded cases of babies surviving this rare type of pregnancy in the UK in the last 20 years. The chances of both mother and baby surviving were three million to one. Nevertheless, Miss Cawte, 38, and fiancé Paul Lounds, 43, from Gloucester, refused to give up on their unborn child and were rewarded when she was born at 30 weeks, weighing 3lb 1oz. ‘We had been trying for over a year to have a baby and there was no way I could terminate when I knew she was healthy,’ said Miss Cawte. ‘We knew it was dangerous. The doctors said I could bleed to death if she ruptured an organ or an artery. Against the odds: Although she was born ten weeks premature, Eva is now thriving ‘But Paul and I agreed that as long as I was in no immediate danger, we continue for as long as possible to give the baby a fighting chance. ‘Now we can’t believe we have such a beautiful, healthy and happy little girl – it’s a miracle.’ The story of little Eva’s fight for survival is remarkable. Miss Cawte, a former recruitment consultant and Mr Lounds, a database administrator, discovered they were going to have a baby in January last year. Everything appeared normal until the 20-week scan that May when doctors discovered the ectopic pregnancy. THE DEADLY COMPLICATION In normal pregnancies, a fertilised egg implants itself in the lining of the womb where it grows and develops. But in an ectopic pregnancy, the egg implants itself in the fallopian tube – which leads from the ovary to the womb. In rarer cases it implants itself in the abdominal cavity or an ovary. Around one in 60 to one in 80 pregnancies are ectopic – and in the vast majority the baby cannot be saved. Often a woman will only realise the pregnancy is ectopic at the first scan between six and ten weeks. Usually it is terminated immediately because of the risks to the mother. If left, the growing foetus may rupture the fallopian tube or other organs which can cause severe internal bleeding. Around five women a year die from an ectopic pregnancy in the UK. They suggested a termination but, because the case was so unusual, they told the couple they would be allowed to terminate, after the 24-week legal limit if they needed more time to think. ‘We both burst into tears,’ said Mr Lounds. ‘We wanted lots of facts but, because the case was so rare, the doctors didn’t have them. ‘Paula was kept in hospital after her scan. It was an incredibly anxious time and she was in intense pain at times.’ Initially, surgeons wanted to deliver at 28 weeks but extended it to 32 weeks so the baby’s lungs could develop. But when doctors discovered there was not enough blood in stock – they needed six pints on standby for Miss Cawte – she was transferred to the John Radcliffe Hospital in Oxford. Surgeons there decided to deliver at 30 weeks. She went into surgery at 11.45am on July 19 last year. Eva was born 45 minutes later and put in the Special Care Baby unit. ‘The nurse told me I had a daughter and I burst into tears,’ said Mr Lounds. ‘I went to see her in an incubator and she looked very tiny but was stable.’ Doctors said she had survived because the membrane of Miss Cawte’s abdomen had created a sac which contained amniotic fluid to help her lungs develop and the placenta was working. But while Eva was in the Special Care Baby Unit, Miss Cawte was in theatre fighting for her life. ‘Paula almost bled to death,’ added Mr Lounds. ‘She had to have eight pints of blood. I sat next to her and told her we had a lovely daughter. She squeezed my hand – she couldn’t speak because she had tubes down her throat. It was a very emotional moment.’ Eva was allowed out of hospital after three months and is developing normally. ‘She’s beautiful, the most stunning looking baby and everything’s on track,’ said Miss Cawte. ‘There’s nothing about her that tells you she was so premature. She smiles a lot and is very content.’ Dr Lawrence Impey, consultant obstetrician at The John Radcliffe Hospital, said: ‘In terms of pregnancy surgery, this is about as risky as it gets. One in every 60 pregnancies is ectopic but only one per cent of those is abdominal. Less than ten per cent of those is advanced like Paula’s.’ Source
