Intraligamentary Pregnancy with Recurrent Urine Retention: Case Report

An intraligamentary pregnancy is an extremely rare form of ectopic pregnancy, with only a few cases reported. We report a 20-year-old woman who had an ongoing pregnancy at about 22 weeks gestation, consulted for recurrent urinary retention and severe lower abdominal pain of two days duration. Pelvic ultrasonography revealed an extrauterine gestation of 19 weeks and four days on the left adnexal region. Exploratory laparotomy was performed that found left intraligamentary pregnancy (unruptured) measured 20 - 25 cm across, attached posteriorly to the bowel (sigmoid colon) and extended to the pouch of douglas impinging on the bladder base. Resection of ectopic pregnancy was successfully performed, urine retention resolved, and the patient was discharged with no postoperative complications. Early recognition of this rare form of ectopic gestation is of considerable importance because of the risk of a life-threatening haemorrhagic complication necessitating emergency surgical intervention.

Broad Ligament Pregnancy:Facing the Battle Unarmed

Broad ligament pregnancy is defined as gestation that grows in the space formed by anterior and posterior peritoneal folds of the broad ligament.We report a case of 30 years old lady admitted to our hospital with the diagnosis of gravida 2,para 1,live birth 1,with 24 weeks of gestation with low lying placenta with anhydramnios.She was taken up for lower segment cesarian section at 28 weeks gestation in view of low lying placenta with chorioamnionitis.The broad ligament pregnancy was diagnosed peroperatively after identifying the anatomical relationship of the pregnancy.Sac was excised and margins secured after extraction of the baby and placenta.Patient had an uneventful postoperative period.Broad ligament pregnancy may be missed in antenatal period but in cases of displaced cervix,early onset unexplained anhydramnios,and failed induction of labor,it may raise high suspicion.Laparotomy/laparoscopic management is the mainstay of management of broad ligament pregnancy.