Background: Incarceration of the pregnant uterus is a rare condition and can lead to bladder obstruction, renal failure, or uterine rupture. We present a novel, noninvasive technique to reduce an incarcerated uterus.
Method: With conscious sedation, the patient was placed in all-fours position. The physician's hands were placed on the patient's abdomen and pressure applied until the uterine fundus was palpated. Gentle, steady fundal pressure on both sides was directed toward the maternal chest (bilateral mediocephalad pressure) elevating the uterus out of the pelvis. This approach successfully reduced the gravid incarcerated uterus and was well tolerated by the patient and fetus.
Experience: The author's experience with this method is limited to this case. Prior experience with reduction of the incarcerated uterus has been with methods previously described in the literature.
Conclusion: In conjunction with conscious sedation and all-fours positioning, transabdominal manipulation of the uterine fundus with bilateral mediocephalad pressure may facilitate reduction of an incarcerated uterus. This method may obviate the need for more invasive procedures.
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Article Synopsis
- This research investigates the ultrasound characteristics and outcomes of incarceration of the gravid uterus (IGU) in pregnant women to assist in medical management.
- A study at Hunan Provincial Maternal and Child Health Care Hospital analyzed 13 diagnosed IGU cases out of 140,162 deliveries, revealing prior abdominal surgery as the main risk factor and dysuria as a common symptom.
- The findings suggest that, while IGU is rare and often has a good prognosis, regular monitoring may be sufficient if there are no severe symptoms, with ultrasound being critical for diagnosis.
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