Pain and inability to void urine after weeks of amenorrhea

A 35 y/o G7, P1, and abortus 5 female with hypogastric pain and inability to void urine after weeks of amenorrhea. She has h/o uterine prolapse 1 year back. Examination showed an anteverted uterus and uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. Ultrasound revealed a cervical length of 30 mm and a singleton, cephalic fetus. How it should be treated?

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Pregnant female Bad obstetric history Uterine and bladder prolapse Acute retention of urine Adv No major surgical intervention is possible because it will result in abortion - and this is a precious pregnancy Bladder prolapse is cause of acute retention of urine , there is no magical cure for same Option 1 Permanent Foley Catheterization till completion of pregnancy Option 2 Clean intermittent self catheterization for voiding of urine till completion of pregnancy Option 3 C. Tamsulosin 400 mcg HS with Tab. Bethanechol 25 mg the times a day There is a good chance that she will be able to pass urine with these medication Final surgical treatment after completion of pregnancy and complete healing after parturition
She is kco habitual abortions Multiparous women with unusual cephalic cervical foetus is cause of anurea Manipulation of foetus Cervical stitches Could give her chance to mature the term if foetus looks viable otherwise medical termination of pregnancy is only option
Thanx dr Priyanka Shinde

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She has multiple preg loss So at present empty the bladder with Foley's catheter Insert the vaginal ring pessary for prolapse Send the urine for routine & microscopic examination Tt if any UTI Regular follow ups
G7 P1 History of habitual abortions Prolapse Now unuseual singletons cephalic fetus So pessary to maneg prolapse Cervical tighting to continue pregnancy without loss If UTI treat accordingly
As she is carrying pregnancy pessary can be used to manage prolapse. Alternatively Foley's catheter can be used for a month
Pessary can be inserted ...pregnancy is continued,can be removed in 2nd trimester
Prolapse should be repaired
Ant. prolaspse uterus
What’s the gestation period cause of abortion may be short CD Pessary can be used
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