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.
In obstetrics, the maternal immune system plays a critical role in the establishment and maintenance of a healthy pregnancy. The immune response of the placenta plays important role in determining a maternal vulnerability toward infectious diseases. The various adverse outcome, ranging from preterm birth, injury to the fetal brain cortex and fetal death are all documented in infected neonates. In obstetrics, viral infections can be either transmitted through the in-utero, intrapartum, and postpartum periods. Nevertheless, with the recent pandemic of coronavirus and some documented cases of a positively infected neonate, it is becoming more apparent that the mode of transmission of coronavirus during pregnancy needs to be better understood. This review focuses on revealing the possible modes of transmission of the coronavirus in obstetrics.
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