Michael Jamie, Kelecha Hebron, Bowen Diana, Watters Amber
Northwestern University, Department of Urology, Chicago, IL, USA.
Northwestern University, Department of Obstetrics and Gynecology, Chicago, IL, USA.
Case Rep Womens Health. 2024 Oct 9;44:e00654. doi: 10.1016/j.crwh.2024.e00654. eCollection 2024 Dec.
Due to advancements in medical care and reconstructive surgery, more patients with bladder exstrophy are reaching reproductive age and considering pregnancy. Complications are more common during pregnancy in this patient population, given medical comorbidities and prior surgical intervention. In the case of cesarean delivery, careful planning is necessary to prevent inadvertent injury to the bladder or bowel segments. This report concerns a patient with a history of infant closure of bladder exstrophy, followed by two bladder augmentations and a catheterizable channel who presented for care at 9 weeks of gestation. Magnetic resonance imaging (MRI) at 36 weeks of gestation was used to delineate the anatomy in planning for cesarean delivery. The patient underwent a successful cesarean delivery at 38 weeks 1 day of gestation. Patients with prior urologic reconstruction can undergo safe cesarean delivery if proper surgical planning is performed. Multidisciplinary care and prenatal MRI are valuable tools for avoiding surgical complications.
由于医疗护理和重建手术的进步，越来越多膀胱外翻患者达到生育年龄并考虑怀孕。鉴于这些患者存在内科合并症和既往手术干预情况，孕期并发症在该患者群体中更为常见。对于剖宫产而言，必须进行仔细规划以防止意外损伤膀胱或肠段。本报告涉及一名有婴儿期膀胱外翻闭合史、随后接受两次膀胱扩大术和一个可导尿通道手术的患者，她在妊娠9周时前来就诊。妊娠36周时进行了磁共振成像（MRI）以在剖宫产规划中描绘解剖结构。该患者在妊娠38周零1天成功进行了剖宫产。如果进行适当的手术规划，既往有泌尿外科重建手术史的患者可以安全地进行剖宫产。多学科护理和产前MRI是避免手术并发症的宝贵工具。
