Uterine Rupture With Simultaneous Bladder Rupture - A Case Report

Abstract

Uterine rupture in pregnancy is a rare and often a catastrophic complication with a high risk of fetal and maternal morbidity and mortality. Uterine rupture associated with urinary bladder rupture is a rare but a challenging situation for a practicing obstetrician. A 29 year old 2 nd gravida with full term gestation with previous LSCS came with complaints of labor pains and P/V leak of 12 hours. There were features suggestive of rupture uterus with simultaneous bladder rupture. A diagnosis of G2P1D1 with term gestation with previous LSCS with rupture uterus with rupture bladder with intrauterine fetal death was made. There was rupture of the previous scar with extension to the anterior vaginal wall with rupture of the posterior wall of the bladder. Uterine and bladder rupture were repaired and peritoneal flap interposed between them and hence conservatively managed. Bladder rupture may be associated with uterine rupture during attempted vaginal birth after cesarean. The potential for bladder injury should be included in the patient's antepartum counseling. KEY WORDS: Rupture uterus, LSCS, labor, vaginal birth after cesarean, bladder rupture. INTRODUCTION:Uterine rupture in pregnancy is a rare and often a catastrophic complication with a high risk of fetal and maternal morbidity and mortality. Rupture of the uterus can occur in a scarred or an unscarred uterus. The risk of uterine rupture ranges from 0.5% to 9% depending upon the type and location of the previous uterine incision. Rupture of the uterus can also involve the other adjacent organs and the most common involvement being the urinary bladder. This being the most common obstetric emergency met in the developing countries.Here we report a case of 2 nd gravida with previous LSCS who presented with rupture uterus with simultaneous rupture of urinary bladder with intrauterine fetal death.