The visceral peritoneum overlying the uterus remained
intact, indicating that the intrauterine pressure was wholly
transmitted to the bladder. We feel that uterine pressure
transmitted to a bladder previously weakened and immo-
bilized by adhesions and distended with trapped urine led to
the bladder laceration. This case illustrates the importance
of continuous cardiotocography as well as the importance
of identifying bladder injury especially in the presence of
gross hematuria.