Stranded under the Prom: impacted gravid uterus presenting as acute urinary retention

Acute urinary retention in pregnancy secondary to an impacted uterus is a rare occurrence. It can have non-specific presentations, leading to delay in diagnosis, hence potentially increasing maternal and fetal morbidity and mortality. A number of risk factors for the condition have been identified. We describe the case of a 31-year-old woman presenting with urinary retention at 18 weeks’ gestation. Clinical examination revealed features consistent with a gravid uterus impacted in the pelvis. Management with urinary catheterisation followed by gentle manual disimpaction of the uterus was successful.

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Christopher LI WAI SUEN, Bachelor of Medicine, Austin Health, Melbourne, Department of Gastroenterology

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Recurrent incarceration of the gravid uterus

Transvaginal ultrasonography showing the retroverted gravid uterus