Broad Ligaments and Pelvic Pain

The broad ligament is part of the structure of a woman's reproductive system. The peritoneum is a membrane that lines the abdominal cavity; the broad ligament is a tentlike fold in the peritoneum that attaches the uterus, Fallopian tubes and ovaries to the pelvis. Disorders of the broad ligament are rare, according to eMedicine, but they can cause pelvic pain.

Anatomy

• A woman has only one broad ligament but it has three parts: mesovarium, mesosalpinx and mesometrium. Sometimes you'll see the three parts referred to as the broad ligaments, even though that's technically inaccurate.

  The broad ligament extends from the sides of the uterus to the sides of the pelvic walls and to the pelvic floor. The function of the broad ligament is to hold the uterus in its normal position, helping maintain its relationship relative to the Fallopian tubes and the ovaries.

Significance in Pregnancy

• Problems with the broad ligament are most likely to occur during pregnancy. Pregnancy can cause tension in the broad ligament, which can lead to hip or pelvic pain. Rarely, an ectopic (outside of the uterus) pregnancy can occur on the broad ligament. All ectopic pregnancies are potentially dangerous. Also, an unusual complication that can occur during delivery or after delivery of a baby is broad ligament hematoma, which is basically a large bruise.

Other Broad Ligament Disorders

• In addition to delivery of a baby, other potential causes of broad ligament hematoma are surgery and trauma.

  A rare cause of chronic pelvic pain in women is Allen-Masters syndrome, also known as the universal joint cervix syndrome. This syndrome has only limited documentation, and not all doctors believe it exists. The theory is that a tear occurs in the connective tissue of the broad ligament, causing excess mobility of the cervix with minimum, if any, uterine movement.

  Another rare occurrence is tumors on the broad ligament. The most common of these rare tumors is a leiomyoma, which is benign and often without symptoms. However, if the tumor becomes large enough, it can push the uterus to the opposite side and potentially compress the ureter (the tube that carries urine from a kidney to the urinary bladder), causing urinary tract obstruction.

  Infection can also affect the broad ligament through parametritis, an infection of the tissue of the peritoneum. Parametritis is considered a type of pelvic inflammatory disease.

Complications

• Hematoma of the broad ligament can be a potentially life-threatening condition. According to eMedicine, common symptoms are back pain, fullness or pressure in the recto-anal area, an urge to push or dizziness. Women may eventually develop low blood pressure and anemia.

Considerations

• Because broad ligament problems are rare, they can also be difficult to diagnose. Magnetic resonance imaging (MRI) is the most common way to diagnose broad ligament disorders.