BackgroundBladder rupture caused by trauma or pelvic fracture is very common, and can be easily diagnosed. However, Spontaneous rupture of the bladder is rare. Reported by Peters PC. (Peters, Urol Clin N Am 16:279–82, 1989): The incidence of spontaneous bladder rupture is 1: 126000. During childbirth, the occurrence rate of this disease is lower than that of the former. It is very difficult to make an early diagnosis of the spontaneous rupture of the bladder during childbirth, which eventually results in high maternal mortality.Due to peritoneal reabsorption, the patient may show high levels of serum creatinine and potassium, and this would easily be misdiagnosed as acute renal failure. However, these patients have normal renal function, hence the diagnosis of renal failure is incorrect.Case presentationA 23 year-old female patient had her first pregnancy and delivered a full-term healthy baby girl. After delivery, the patient developed fever, oliguria, massive ascites, high serum creatinine and high serum potassium. The patient was initially diagnosed with acute renal failure, however treatment for her condition was ineffective. After further examination, the patient was diagnosed with intraperitoneal bladder rupture. The patient was treated for bladder rupture, made a full recovery and was discharged.ConclusionsSudden onset of massive ascites and renal failure due to abnormal serum biochemical characteristics after delivery should be first diagnosed as spontaneous bladder rupture. However, bladder radiography may suggest a false negative result, hence cystoscopy should be performed to confirm the diagnosis. The ratio between ascites creatinine and serum creatinine would be helpful for early diagnosis and to determine the time of rupture. Conservative management or surgical repair should be used to treat bladder rupture.

Objective. To study the effect of health education combined with personalized psychological nursing intervention on pregnancy outcome of pregnant women with gestational diabetes mellitus (GDM). Methods. 170 patients with GDM admitted to Guangdong Women and Children Hospital from January 2018 to December 2018 were selected as study subjects and randomly divided into two groups. During the period from diagnosis of GDM to termination of pregnancy, both groups were given routine education and routine examination, and the intervention group adopted health education combined with personalized psychological nursing interventions during pregnancy. The pregnancy weight, blood glucose index, compliance, disease awareness, self-adjustment management ability, satisfaction, and pregnancy outcome were measured before and after the intervention. Results. There were no statistically significant differences in pregnancy weight, fasting plasma glucose, and 2 h postprandial blood glucose between the two groups before intervention ( P = 0.768 , 0.605, and 0.762). After intervention, lower levels of the above indicators were obtained in the intervention group than in the control group ( P < 0.001 ). The compliance and satisfaction with the intervention in the intervention group were significantly higher than those in the control group ( P < 0.001 ). The intervention group had remarkably higher disease awareness rate and self-psychological adjustment and management ability than the control group ( P < 0.001 ). Better pregnancy outcomes were observed in the intervention group compared with the control group ( P < 0.001 ). Conclusion. For patients with GDM, health education combined with personalized psychological nursing on the basis of the conventional nursing can effectively control patients’ condition and ensure a better pregnancy outcome, which merits widespread promotion.