TITLE:
Prolonged Obstructed Labor Is an Uncommon Presentation of a Giant Bladder Calculus: A Case Report and Literature Review
AUTHORS:
B. M. Abubakar, A. Abdulkadir, A. A. Atterwahmie, A. A. Atterwahmie, A. A. Panti, A. I. Maina
KEYWORDS:
Prolonged Obstructed Labor, Giant Calculus, Primary Presentation
JOURNAL NAME:
Open Journal of Urology,
Vol.9 No.4,
April
26,
2019
ABSTRACT: Prolonged obstructed labor is a critical intrapartum emergency. This intricacy
is, however, unusual as a primary presentation of a giant bladder calculus. We
report a case of a 25-year-old Para 6 + 1, who presented with a history of labor
pains of 72 hours duration. She had background lower urinary tract
symptoms with supra-pubic swelling and hematuria of 2 years duration. She
had a single antenatal visit at 32 weeks however; no obstetric ultrasound scan
was done before she went into labor. Examination revealed a highly placed
fetal head with increase fetal heart rate. There was a hard mass bulging under
the anterior vaginal wall. The diagnosis was a prolonged obstructed labor
secondary to bladder mass with fetal distress was made. She had a caesarean
section (CS) with the delivery of fresh stillborn. The bi-manually palpable
bladder mass persisted post-CS. Her abdominopelvic ultrasound scan and
abdominal X-ray post-CS revealed giant vesical calculus with obstructive
uropathy. Urine microscopy culture and sensitivity yielded E. coli sensitive to
Ciprofloxacin; other laboratory investigations were normal. She was treated
for UTI and 2 weeks post-CS, she had opened cystolithotomy. The stone
weighed 536 g. Her postoperative recovery was uneventful.