Multidisciplinary Management of Pregnancy in Bladder Exstrophy: A Case Report

Area of Science:

• Urology
• Obstetrics
• Congenital Anomalies

Background:

• Classic bladder exstrophy (CBE) is a rare congenital condition impacting urinary and musculoskeletal systems.
• Management involves complex reconstructive surgery for renal function, continence, and reproductive health.
• Pregnancy in women with CBE presents risks like UTIs, prolapse, and preterm birth.

Purpose of the Study:

• To report a case of pregnancy in a woman with a history of CBE.
• To highlight the management and delivery of a complicated pregnancy in a patient with CBE.
• To emphasize the importance of multidisciplinary care in such cases.

Main Methods:

• Case report of a 33-year-old woman with CBE and a complicated pregnancy.
• Management involved a multidisciplinary team addressing recurrent UTIs, anemia, gestational diabetes, uterine prolapse, and altered anatomy.
• Delivery planned via elective cesarean section at 37 weeks due to fetal growth concerns and breech presentation.

Main Results:

• The pregnancy was complicated by recurrent UTIs, anemia, gestational diabetes, and stage IV uterine prolapse.
• Imaging revealed altered abdominal anatomy and breech fetal presentation.
• Elective cesarean delivery and postpartum recovery were uneventful despite the patient's complex history.

Conclusions:

• Pregnancy management in CBE patients necessitates close, multidisciplinary collaboration.
• Detailed delivery planning and vigilant monitoring are crucial for maternal and fetal safety.
• Successful outcomes are achievable with comprehensive, team-based care.