Incarcerated Gravid Uterus in a Nulliparous Female Presenting With Urinary Hesitancy and Rectal Pressure: A Case Report

Incarcerated gravid uterus (IGU) is a rare condition that is associated with urinary obstruction, sepsis, peritonitis, and ultimately maternal death. IGU occurs when the retroverted uterus in a gravid patient becomes trapped in the pelvis during the second trimester. We present the case of a nulliparous female who came to our emergency department (ED) at 14 weeks and five days gestation with new onset intermittent urinary hesitancy and rectal pressure starting approximately 10 days prior to presentation. IGU was diagnosed based on pelvic examination and ultrasound in the ED. Emergency physicians should have a high index of suspicion for IGU in their differential diagnosis for pregnant females with urinary and rectal complaints. Point-of-care ultrasound (POCUS) should be used as an adjunct in identifying this condition.