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为患有先天性膀胱外翻的孕妇实施保留新膀胱的剖宫产术。

Neobladder saving caesarean section in a pregnant woman with congenital bladder exstrophy.

作者信息

Granieri Chiara, D'Ippolito Silvia, Foresta Aniello, Gui Benedetta, Foschi Nazario, Esposito Giovanni, Scambia Giovanni

机构信息

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.

Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, UNIMOL, Via Francesco De Sanctis 1, 86100, Campobasso, Italy.

出版信息

Arch Gynecol Obstet. 2025 Apr;311(4):1221-1225. doi: 10.1007/s00404-025-07937-4. Epub 2025 Jan 31.

Abstract

PURPOSE

To propose an obstetric management model for patients with congenital bladder exstrophy (BE) and multiple previous surgeries, recognizing the unique anatomical variations of each patient and emphasizing the importance of personalized treatment approaches.

METHODS

We present the obstetric management and delivery of a 32-year-old pregnant woman with congenital BE, focusing on antenatal anatomical assessment, accurate delivery planning and key surgical steps during an elective caesarean section. Additionally, we conduct a comprehensive review of the current literature to enhance understanding of the reproductive implications associated with this exceptionally rare condition.

RESULTS

Following urological magnetic resonance imaging and intraoperative ultrasound, a successful neobladder-saving caesarean section was performed at 37 weeks, resulting in the delivery of a healthy infant with no maternal complications.

CONCLUSION

Obstetric management in women with congenital BE presents unique challenges due to its significant impact on urinary and reproductive functions. Careful delivery planning and antenatal anatomical assessment are crucial for optimizing both maternal and fetal outcomes. A personalized, multidisciplinary approach can help minimize potential complications.

摘要

目的

为先天性膀胱外翻(BE)且既往接受过多次手术的患者提出一种产科管理模式,认识到每位患者独特的解剖变异,并强调个性化治疗方法的重要性。

方法

我们介绍了一名32岁先天性BE孕妇的产科管理及分娩情况,重点关注产前解剖评估、准确的分娩计划以及择期剖宫产术中的关键手术步骤。此外,我们对当前文献进行了全面综述,以加深对这种极其罕见疾病相关生殖影响的理解。

结果

经泌尿外科磁共振成像和术中超声检查后,在37周时成功实施了保留新膀胱的剖宫产手术,产下一名健康婴儿,产妇无并发症。

结论

先天性BE女性的产科管理因其对泌尿和生殖功能的重大影响而面临独特挑战。精心的分娩计划和产前解剖评估对于优化母婴结局至关重要。个性化的多学科方法有助于将潜在并发症降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68ba/11985548/2a09657a9bda/404_2025_7937_Fig1_HTML.jpg

相似文献

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Successful pregnancy in a patient with previous bladder exstrophy.
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Uterine prolapse associated with bladder exstrophy: surgical management and subsequent pregnancy.膀胱外翻合并子宫脱垂:手术治疗及后续妊娠
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本文引用的文献

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Complex maternal congenital anomalies - a rare presentation and delivery through a supra-umbilical abdominal incision.
J Obstet Gynaecol. 2018 Aug;38(6):874-875. doi: 10.1080/01443615.2017.1394282. Epub 2018 Feb 13.
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Pregnancy outcomes among patients with prior bladder exstrophy.
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