Uterine Incarceration During the Third Trimester: A Rare Complication of Pregnancy

Winter, Jo T. Van; Ogburn, Paul L.; Ney, Judith A.; Hetzel, David J.

doi:10.1016/s0025-6196(12)60520-5

Cited by 65 publications

(69 citation statements)

References 5 publications

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“…9 Cases of maternal and foetal death have also been described. 10,11 The incidence of incarcerated uterus has been quoted to be around 1 in 3000 to 10,000 cases. 12 In the authors' institution where electronic medical record has been used over period of 5 years involving more than 60,000 deliveries, this is the first case ever recorded.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Technically challenging trans-vaginal caesarean deliveries have been described late gestations in uncorrected cases. [3][4][5] We report an interesting case of an incarcerated gravid uterus who had a spontaneous uterine repositioning following general anaesthesia without any further need for manual manipulation. Based on this report, we believe that the management of incarcerated uterus at late gestation is feasible with the aid of general anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous repositioning of incarcerated gravid uterus following general anaesthesia: a case report and review of literature

Ramli

Abdullah

Yusoff

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spontaneous repositioning of incarcerated gravid uterus following general anaesthesia: a case report and review of literature

Ramli

Abdullah

Yusoff

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…More recently, however, there have been reports in the literature of asymptomatic retroversion in the third trimester 5,6 where the diagnosis was not been made until caesarean section was performed.…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment of an incarcerated gravid uterus

Hamoda¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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a Case reportA 24 year old woman in her first pregnancy was admitted at 18 weeks of gestation with acute urinary retention. This was preceded by a one-week history of urinary frequency, passing small volumes of urine. On examination, the posterior vaginal wall was pushed forward and the cervix was high behind the symphysis pubis; urethral catheterisation drained 1000 mL of urine. A pelvic ultrasound examination was interpreted as showing a fundal fibroid measuring 7.6 Â 8.0 Â 9.4 cm within the body of the uterus, situated posterior to the bladder, low in the pelvis. The urethral catheter was removed after 24 hours and the woman was discharged home.She was admitted five days later with further urinary retention requiring recatheterisation. Repeat ultrasound examination again showed a retroverted uterus with the fibroid low on the anterior wall. Magnetic resonance imaging confirmed the retroverted uterus occupying the pelvis in front of the sacral promontory, the fibroid on the anterior wall and placenta on the posterior uterine wall (Fig. 1). The risks and uncertainties about the outcome for her and her pregnancy were discussed; she preferred conservative treatment rather than the termination of her pregnancy. The catheter was removed, with apparently satisfactory spontaneous voiding. She was discharged home.Two weeks later at 22 weeks of gestation, she was admitted with abdominal pain and tenderness, and a diagnosis of probable fibroid degeneration was made; this was treated conservatively. The following day, she again developed urinary retention and was catheterised for 24 hours. The urinary infection was treated with antibiotics. She was taught intermittent self-catheterisation before discharge, but she managed to avoid further urinary retention by applying suprapubic pressure at regular intervals.Further ultrasound examinations were performed at 28 and 32 weeks of gestation. These showed persistence of the retroversion; the fetal lie remaining longitudinal with the breech low in the maternal pelvis; and normal fetal growth measurements were recorded. Delivery by elective caesarean section was planned at 36 weeks of gestation.In theatre, an ultrasound examination showed the lie was transverse and that the retroversion had probably corrected. At caesarean section, the corrected uterine position was confirmed, as was the low anterior wall fibroid; the uterus was otherwise normal. A transverse incision was made in the lower segment below the fibroid and a baby boy weighing 2493 g was delivered by breech extraction; his Apgar scores were 9 and 10 at 1 and 5 minutes, respectively. The fibroid was removed at the time of the caesarean Fig. 1. Sagittal T2 weighted fast spin magnetic resonance image at 20 weeks of gestation showing the uterine fundus containing the breech (curved arrow) in the Pouch of Douglas. The placenta (*) is attached to the posterior uterine wall with a large intramural fibroid (arrowheads) superiorly on the lower portion of the anterior wall, with the cervix (arrows) just below, above the level ...

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“…Review of some relevant articles [2,[4][5][6][7][8][10][11] shows that most of the retentions occur between 12 and 16 weeks' gestation, pain is usually severe and a soft, tender bladder is usually palpable, with retained urinary volume always above 500 ml without signs or symptoms of urinary tract infection. There are, however, cases in which uterine incarceration manifested during the third trimester or at term [10].…”

Section: Discussionmentioning

confidence: 99%

“…There are, however, cases in which uterine incarceration manifested during the third trimester or at term [10]. These rare cases are very difficult to diagnose and should be monitored closely during subsequent pregnancies, as they may recur.…”

Section: Discussionmentioning

confidence: 99%

Severe edema of the uterine cervix — an unusual cause of acute urinary retention in pregnancy

1995

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A very unusual case of a healthy pregnant patient who developed recurrent acute urinary retention is described. A 34-year-old multiparous woman was admitted to the hospital in the 17th week of gestation with acute urinary retention and complete obstruction of the urethra. The reason for this was an enormous enlargement of the uterine cervix -possibly an acute allergic reaction to a new kind of a body lotion. She was treated with catheterization during the acute episode, and prolonged use of a vaginal ring pessary. She was admitted again several times at later stages in the pregnancy, with the same complaint. The possible reasons for such repeated episodes of retention and the need for prompt diagnosis and treatment are discussed.

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Uterine Incarceration During the Third Trimester: A Rare Complication of Pregnancy

Cited by 65 publications

References 5 publications

Spontaneous repositioning of incarcerated gravid uterus following general anaesthesia: a case report and review of literature

Spontaneous repositioning of incarcerated gravid uterus following general anaesthesia: a case report and review of literature

Conservative treatment of an incarcerated gravid uterus

Severe edema of the uterine cervix — an unusual cause of acute urinary retention in pregnancy

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