Pregnancy after repaired bladder exstrophy: a case report.

Area of Science:

• Reproductive Medicine
• Urology
• Congenital Anomalies

Background:

• Bladder exstrophy (BE) is a rare congenital anomaly requiring surgical repair in childhood.
• Pregnancy in individuals with repaired BE presents significant risks, including decreased fertility, miscarriage, preterm birth, and postpartum complications.
• An extreme bicornuate uterus adds further complexity to pregnancy management.

Observation:

• A 27-year-old primigravida with a history of repaired bladder exstrophy and an extreme bicornuate uterus presented for pregnancy management.
• The patient experienced cervical shortening, recurrent antibiotic-resistant urinary tract infections (UTIs), pelvic girdle pain, and postpartum urinary incontinence.
• This high-risk pregnancy necessitated management by a large multidisciplinary team.

Findings:

• Despite the complex medical history and complications, the pregnancy was successfully managed.
• The patient achieved a term pregnancy.
• Delivery was accomplished via an elective, individualized cesarean section.

Implications:

• This case underscores the importance of multidisciplinary care in managing high-risk pregnancies in patients with repaired bladder exstrophy.
• Successful term delivery is achievable even with significant anatomical challenges and complications.
• Further research into optimizing pregnancy outcomes for this patient population is warranted.