Abstract
Introduction:
Uterine rupture during pregnancy is a rare event which can be life-threatening for both the patient and the fetus. This case report describes a rare complication of uterine rupture which ultimately required a hysterectomy and extensive urologic reconstruction.
Case Description:
A 36-year-old patient presented to the hospital after term pre-labor rupture of membranes. The patient underwent induction of labor which ultimately resulted in a uterine rupture in an unscarred uterus. The rupture extended into the posterior bladder wall, right ureter, urethra, and anterior vaginal wall, resulting in a vesicovaginal fistula. The patient required a cesarean hysterectomy due to the uterine damage. Cystorrhaphy with right percutaneous nephrostomy tube and suprapubic catheter placement were performed due to the extensive urologic sequelae. Months later, the patient underwent ureteroneocystostomy for definitive urologic management.
Discussion:
Bladder rupture is a rare complication of uterine rupture and can occur in an unscarred uterus. Intrapartum bladder rupture should be considered in patients who develop gross hematuria or anterior vaginal wall laceration in the setting of uterine rupture. Maternal morbidity and mortality due to uterine rupture is decreased when care is provided at a tertiary referral or trauma center. This should be taken into consideration when planning deliveries with an increased risk of uterine rupture. Furthermore, providers performing vaginal deliveries should be aware of this rare complication to optimize maternal and neonatal outcomes.
Recommended Citation
Hoskins NN, Brandt K, Peterson T. Catastrophic Spontaneous Uterine and Bladder Rupture in an Unscarred Uterus. Transformative Medicine. 2024; 3(3):95-97. doi: https://doi.org/10.54299/tmed/luyd5797.