Successful Pregnancy in a Patient with Previous Bladder Exstrophy

Abstract

Bladder exstrophy is an unusual congenital anomaly. Patients becoming pregnant with such anomaly after surgical repair are even rarer. The present case reports a lower segment Caesarean section delivery of a living healthy baby in a woman who had been operated on for bladder exstrophy at the age of 18 years. This is the first case of this type seen in our institution in 35 years.

Mifepristone and misoprostol versus misoprostol alone in management of late intrauterine fetal death

“…8 In our study, induction to delivery interval was less in group pretreated with mifipristone. Our study is in agreement with the study of Vayrymen et al, and Sharma et al 11,12 Induction to delivery interval was shortest (7 hours) in study of Fairley et al, while it was maximum (12.8 hours) in study of Vayrymen et al 8,11 In our study it was 9.8 hours in combination regimen. Dosage of misoprostol required was significantly less in the mifipristone group which can be explained due to its pharmacodynamics as mentioned earlier.…”

Successful Pregnancy and Delivery in a Patient with Bladder Exstrophy

“…Defects in the development of the urogenital tract result in various congenital anomalies of this system, such as widely separated pubic bones, low-lying umbilical cord insertion and bifid clitoris. 1 Due to the close embryological relationship between the genital and urinary systems, complex urogenital and intestinal anomalies are common in patients with BE. In a series of 79 patients, Blakeley and Mills 11 and Stanton 12 identified urogenital anomalies (uterine agenesis, vaginal septum, and renal agenesis) in 50% of the patients.…”

“…1 However, patients with indications for cesarean delivery for obstetric reasons should be considered exceptions. Vaginal delivery may be performed easily and without complication in patients without prolapse not undergoing vaginal, clitoral, or urogenital reconstruction.…”

“…1 We had also planned an elective cesarean delivery for the present patient with the assistance of a pediatric urologist. However, the obstetric findings of the present case were suitable and the fetus was in cephalic presentation; thus, in the present case, a vaginal delivery with an episiotomy was performed without complications.…”

Management of narrow introitus with Fenton's operation followed by successful pregnancy in a woman with repaired bladder exstrophy

“…Th e quality of life of these individuals is considerably aff ected with an array of problems, such as urinary incontinence, prolapse, problems in social integration, psycho-sexual life, pregnancy complications, newborn care, etc. Pregnancies have been reported in these women (Sayeeda et al 2012;Sharma et al 1998;Ikeme 1981;Mariona and Evans 1982;Mathews et al 2003). Managing pregnancy is unique in these women, despite repair due to deformities of external genitalia, pelvic fl oor defects, expected post-surgical dense lower abdominal adhesions involving the bladder and absence of anterior pelvis.…”