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Published on: August 9, 2012
Reproductive outcomes in women with classic bladder exstrophy: an observational cross-sectional study
Rebecca Deans1, Frederick Banks, Lih-Mei Liao
1Royal Hospital for Women and University of New South Wales, Sydney, NSW, Australia.
Objective:
We sought to examine the reproductive outcomes of 52 women with classical bladder exstrophy.
Study Design:
This was an observational study with cross-sectional and retrospective arms.
Results:
The average age of the sample was 33 years (range, 17-63). Of those who had tried, 19/38 (66%) had conceived. A total of 57 pregnancies (3 sets of twins) were reported for the 19 patients and resulted in 34/57 live births (56%), 21/57 miscarriages (35%), 1/57 (2%) termination, and 4/57 (7%) stillbirths or neonatal deaths. Four deliveries resulted in major complications including 1 transection of the ureter (4%), 1 fistula formation (4%), and 2 postpartum hemorrhages (8%). There were 2 admissions to intensive care, one for urinary sepsis and another for massive obstetric hemorrhage.
Conclusion:
Fertility is impaired in women with bladder exstrophy. Pregnancy is high risk both for the mother and baby. Delivery should be at a tertiary referral obstetric unit with urology cover. In the majority of cases planned cesarean section is the most appropriate mode of delivery.
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