Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of early detection of interstitial ectopic pregnancy resulted in a maternal near-miss and calls for the need for increased awareness and high index of suspicion among sonographers and clinicians. A case of a 24-year-old gravida two para zero, one previous ectopic pregnancy (G2P0 1EP ) was brought into our facility with generalized abdominal pain and hemorrhagic shock. She had a previous history of left salpingectomy for a ruptured tubal ectopic pregnancy four years earlier at a secondary health care facility. Emergency laparotomy after aggressive resuscitation revealed ruptured interstitial ectopic pregnancy with massive hemoperitoneum and a dead fetus. Wedge resection of the right cornua along with the Fallopian tube was done. Diagnosis of interstitial ectopic pregnancy is challenging due to its rarity and location in the intrauterine portion of the Fallopian tube. Ultrasonographic diagnosis in early pregnancy is key. Awareness creation and a high index of suspicion is required among sonographers and clinicians to prevent needless morbidity and mortality.

There is paucity of scientific data on intussusception in pregnancy globally which makes it a rare clinical occurrence. The symptoms in pregnancy may mimic obstetric conditions and thus presents a diagnostic dilemma to clinicians. A high index of suspicion is therefore needed in order to establish a preoperative diagnosis. We present a 29-year old woman, gravida 5 para 4, 2 alive and 2 dead (G5P4 2A+2D) at 23-weeks' 6 days gestation from northern Ghana, who was referred to Tamale Teaching Hospital (TTH) as a case of acute abdomen. Initial clinical assessment and bedside ultrasonography led to a diagnosis of intussusception. A viable colo-colic intussusception was found on open laparotomy and a left hemicolectomy was performed. This was confirmed by histopathological examination of the resected bowel. There was no identifiable lead point. This case report illustrates how good and prompt initial clinical assessment supported with imaging led to a successful outcome of acute abdomen in pregnancy in a low-middle resource country.