A pregnant women, previous LSCS with hematuria. Diagnosis is?
Prolonged labour Make it clear once and for all:? "Hematuria is not a feature of impending scar rupture". How would an impending scar produce hematuria??? Hentaturia indicates bladder involvement - In some cases of uterine rupture, bladder rupture can also occur. These cases of utrine rupture presents with hematuria. "So hematuria in a case of uterine rupture indicates that rupture has actually taken place, it is not impending". "Hematuria only occurs in uterine rupture when rupture has actually occurred and involved bladder too". A common cause of hematuria during labour is obstructed labour. "In obstructed labour the bladder becomes an abdominal organ and due to compression of urethra between the presenting pa and symphysis pubis, the patient .fails to empty the bladder. The transverse depression at the junction of the superior border of the bladder and the distended lower segment is often confused with the Bandls's ring. The bladder wall gets traumatized which may lead to blood stained urine, a common finding in obstructed labour". Clinical features of impending scar rupture: ? Tenderness over the site of uterine scar. Uterine contractions become tetanic. Signs of extreme fetal distress or death. Maternal tachycardia. Slight elevation in maternal temperature.
Impending scar rupture of uterus
Prolonged labour
Uretreral injury
Cystitis