[Measurement of boundary line of urinary bladder and peritoneum in abdominal wall and the application in performing cesarean section with urinary bladder reversal method].

OBJECTIVE

To provide the basic research data and clinical application in performing extraperitoneal cesarean section (CS) with urinary bladder reversal method.

METHODS

The position and the surface projection of the vesico-peritoneal fold and the apex of the urinary bladder were measured in 107 cases of term pregnant women (37-42 weeks, aged 20-40).

RESULTS

The distance from the bladder apex to the umbilicus and to the symphysis pubis were (14.1 +/- 3.4) cm and (6.8 +/- 1.4) cm respectively, while from the utero-vesical pouch to umbilicus and symphysis pubis were (15.8 +/- 3.9) cm and (4.9 +/- 1.5) cm respectively. During late pregnancy the projection of bladder apex was located at the point between the middle and the lower 1/3 of the line from umbilicus to symphysis pubis; while the utero-vesical pouch was located at the point between upper 3/4 and the lower 1/4 of the same line. The time interval from the start of operation to the delivery of baby was (14.56 +/- 6.3) min, and the total operation period was (45.5 +/- 9.3) min. The largest baby weighed 5,050 gm and there was no bladder injury.

CONCLUSION

To define the position of vesical peritoneal fold would give benefit to the extraperitoneal CS with bladder reversal method which was performed under direct visualization and could avoid injury of bladder.