33岁初产妇，孕39周，临产16小时。腹痛 难忍，烦躁。产科检査：宫底剑突下2横 指，拒按，脐下2横指处见一凹陷，随宫缩 逐渐上升，宫口开大4cm，S-1.5, ROP 位，产瘤5cm x 5cm x 1. 5cm，儿头塑形明 显，胎心率68次/分。导尿为肉眼血尿。此 时应做下列何种诊断(       )

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