'Unprecedented': Woman delivers full-term abdominal pregnancy while also having 22-pound cyst removed

A woman in California was scheduled to have a large cyst removed and tested positive on a routine pregnancy test just prior to the procedure. She would soon learn that she actually had a full-term baby tucked away in her abdomen, hidden behind the cyst.

Suze Lopez, a 41-year-old emergency room nurse from Bakersfield, underwent a procedure to have both the cyst removed and her baby delivered at the same time. The effort involved about 30 medical professionals at Cedars-Sinai Medical Center in Los Angeles.

Lopez began hemorrhaging after the baby was delivered but was stabilized by the medical team, who used 11 units of blood to do so, according to a statement from Cedars-Sinai. (For context, a typical blood donation is about one pint of blood, which is one unit.)

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The baby, who weighed 8 pounds (3.6 kilograms) at birth and had a full head of hair, was quickly transferred to the neonatal intensive care unit (NICU) after birth. All things considered, he was remarkably healthy, his physicians said.

"I was amazed by this little guy," Dr. Sara Dayanim, a neonatologist with Cedars-Sinai Guerin Children's, said in a video accompanying the announcement. "He's defied all odds," she said.

How the pregnancy went undetected

The baby, named Ryu, was discovered because Lopez was scheduled to have a 22-pound (9.9 kg) ovarian cyst removed. The cyst was noncancerous, but it had been growing for years by the time Lopez was scheduled to undergo the surgery.

Lopez was used to experiencing irregular periods and abdominal discomfort, so she didn't expect to get a positive result on the pregnancy test prior to the surgery. She surprised her husband Andrew with news of the pregnancy while at a Dodgers baseball game in Los Angeles; the pair snapped a selfie together while holding up a Dodgers-branded onesie.

However, later at the game, Lopez started to have intense abdominal pain, and they immediately went to Cedars-Sinai.

Lopez arrived at the hospital with very high blood pressure, and as medical staff set about treating it, they also ran blood work and body scans, including an MRI and ultrasound. That's when they discovered that Lopez was carrying a rare abdominal ectopic pregnancy. The baby was situated near the liver, with his back half resting on top of the uterus.

"It was the baby growing in her abdomen behind the mass that was pushing everything out," Dr. John Ozimek, medical director of Labor and Delivery and the Maternal-Fetal Care Unit at Cedars-Sinai, said in the video. "So that's the reason she didn't know she was pregnant."

He added that "a pregnancy this far outside of the uterus that is living is pretty much unprecedented."

Ectopic pregnancies occur outside the uterus and account for roughly 2% of all pregnancies. All forms of ectopic pregnancy, in any location in the body, are life-threatening, as they can rupture organs and cause catastrophic bleeding and, potentially, shock due to blood loss. Ectopic pregnancies cannot be transferred into the uterus, and as such, medical guidance is to treat the condition by ending the pregnancy, either with medication or surgery.

The vast majority of ectopic pregnancies — about 95% — occur in a fallopian tube, a tube that shuttles eggs from an ovary to the uterus. Abdominal ectopic pregnancies, by comparison, occur in only about 1% of ectopic pregnancy cases.

If an ectopic pregnancy escapes notice — as in this case — it's very improbable that the fetus would develop normally outside the uterus. Thus, fetal death is likely.

That said, the medical literature includes a handful of unusual cases in which abdominal ectopic pregnancies were discovered very late in gestation and ultimately resulted in the birth of healthy babies.

In Lopez's case, "we had to figure out how to deliver the baby with a placenta and its blood vessels attached in the abdomen, remove the very large ovarian mass and do everything we could to save mom and this child," Dr. Michael Manuel, a gynecological oncologist at Providence Cedars-Sinai Tarzana Medical Center, said in the statement. And in the end, they were successful.

Lopez, who has a teenage daughter, had been hoping for a second pregnancy for years.

"I could not believe that after 17 years of praying, and trying, for a second child, that I was actually pregnant," she said in the statement. "I appreciate every little thing. Everything. Every day is a gift and I'm never going to waste it."