The urinary bladder functions normally during pregnancy; however, when a retroverted uterus is present during the pregnant state, the bladder may not empty properly. Severe uterine retroflexion can result in complete obstruction of the urinary channel. The obstruction is caused by the expanding uterus being securly wedged between the os pubis and the sacrum, with the urethra occluded at the point where pressure is exerted by the cervix.
In the available literature there are three reports of patients who suffered complete urinary retention in pregnancy due to uterine retroflexion: Smellie (1876)1; Crabtree (1942)2; and Burdon, Maurer, and Lich Jr. (1951).3 All of these patients were in the fourth month of pregnancy; the patient reported on in this paper was in the third month. In all four cases the degree of retroflexion was complete, so as to prevent the rise of the uterus out of the true pelvis.
Spring M, Hymes JJ. ACUTE URINARY RETENTION AS A COMPLICATION OF PREGNANCY: REPORT OF A CASE. JAMA. 1952;149(11):1011–1012. doi:https://doi.org/10.1001/jama.1952.72930280002009a
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