中期妊娠引起膀胱尿潴留属少见的产科急症,我科于1988年2月至6月曾遇4例,其中2例(例1、例4)病情较重,收入住院治疗,另2例经门诊处理即愈,4例均为初孕妇,其临床资料见附表。附表4例妊娠合并膀胱尿潴留临床资料例孕周排尿困难时间不能排尿时间膀胱底位置一次最多导尿双合诊检查子宫大小宫体位置宫颈位置肛诊B 超检查子宫复位1 17 30天3天剑突下6000ml 如孕4月大小后倾后屈嵌于子宫直肠凹内未触及宫颈手指进入肛门即触及宫底子宫倒立直位,宫颈耻骨联合上3cm,膀胱充盈,双输尿管扩张,肾盂积水胸膝卧位双合诊复位成功2 14 3天1天脐上4指2000ml 如孕3月大小嵌于骶骨凹内在耻骨联合后方手指进入肛门触及宫底未查膀胱截石位双合诊复位成功3 15 2天半天脐上2指1700ml 如孕3月大小嵌于骶骨凹内在耻骨联合后方手指进入肛门3cm 触及宫底未查导尿后子宫自动复位4 12 5天2天脐上4指5000ml 如孕2.5月大小前倾前屈正常未查未查子宫位置正常讨论一、病因:中期妊娠致膀胱尿潴留以往文献报道极少,因为妊娠3个月以后子宫多能升入腹腔,不会压迫尿道。若膀胱充盈后不及时排尿,待膀胱顶超过子宫底高度时,可将子宫压向盆腔,随着膀胱尿量的增加,其对子宫的压力也逐渐增大,终使子宫体嵌顿于子宫直肠窝内,而子宫颈则有不同程度的上举 Intermittent bladder urinary retention caused by a rare obstetric emergency, our department in February 1988 to June had 4 cases, of which 2 cases (case 1, case 4) a serious condition, income hospitalization, and the other two outpatients Jiyu treatment, 4 cases are pregnant women, the clinical data, see the attached table. Schedule 4 cases of pregnancy with bladder urinary retention clinical data cases of gestational week dysuria time can not urination bladder position at a time the most catheterization double check the uterus size palace position cervical position anus B ultrasound examination uterine reset 1 17 30 days 3 Stroke of the 6000ml, such as pregnancy, after the size of the dump in April after the bend in the uterine rectum concave untreated cervical finger into the anus that touch the uterus in the uterus upside down straight position, cervical pubic symphysis 3cm, bladder filling, double ureteral dilatation, Water chest knee Shuanghe diagnosis successful reset 2 14 3 days 1 day Umbilicus 4 means 2000ml If the size of pregnancy in March embedded in the sacral concave The pubic symphysis behind the finger into the anus touched the bottom of the palace Did not check the bladder lithotomy double joint reset Succeeded 3 15 2 days half day Umbilicus 2 means 1700ml If pregnant March Size Embedded in the sacrum concave Rear of the pubic symphysis into the anus 3cm Touch the uterus at the end of the uterus Did not check the urine Uterine automatic reset 4 12 5 days 2 days Umbilicus 4 means 5000ml Such as pregnancy 2.5 months before the anteversion of the flexion of the normal did not check the location of the uterus is not discussed a normal etiology: bladder infection caused by medium-term pregnancy in the past few reports of the literature, because the uterus after 3 months of pregnancy can rise into the abdominal cavity, will not pressure Urethra. If the bladder is not timely urination after filling, until the top of the bladder beyond the height of the uterus, the uterus can be pressed against the pelvis, with an increase of bladder urine, the pressure on the uterus also gradually increased, finally uterine incarceration in the uterus Rectal fossa, while the cervix has varying degrees on the move