Urinary Retention in Pregnancy

Uterine incarceration is a fairly rare occurrence with an incidence of only about 1 : 3000 pregnancies. Caused by uterine retroversion him, trapped behind the sacral promontory and fixed for the remainder of the pregnancy. Between 12-20 weeks gestation, the patient will complain of lower abdominal pain, constipation, urinary incontinence, urinary retention, or even urinate constantly.

Fernandes et al (2012) noted in 10 years at a hospital in Boston occurred eight cases of uterine incarceration. The risk is spontaneous abortion. In some severe cases, the uterus may interfere with the attitude of the bladder and rectum, so as causing rupture of the bladder and rectum gangrene.

Incarceration of the uterus can lead to misdiagnosis as ectopic pregnancy, the uterus is experiencing retroflexi part, presumed gestational sac cul - de -sac while the inferior part of the uterine endometrium unexpectedly empty. Ultrasound will show that the length of the cervix appears anterosuperior position. Fundus will be in the posterior, located next to the pelvic cavity.

In a journal written on J Ultrasound Med 2012; 31:645-50, Fernandes et al revealed that the repositioning of the uterus during pregnancy should be done between 14-20 weeks old. The patient was placed with the dorsal lithotomy position, then paired urinary catheter, and hand pressed bimanually the uterus. One finger went into the rectum, and then increase the pressure on the uterus. If difficult to do with regional anesthesia, this procedure can be performed laparoscopically or even laparotomy. Having returned to the position anteflexi uterus, uterine pessarium fitted for a week in order not to go back into retroversion.