Reproductive outcomes in women with classic bladder exstrophy: an observational cross-sectional study

Royal Hospital for Women and University of New South Wales, Sydney, NSW, Australia.
American journal of obstetrics and gynecology (Impact Factor: 3.97). 03/2012; 206(6):496.e1-6. DOI: 10.1016/j.ajog.2012.03.016
Source: PubMed

ABSTRACT We sought to examine the reproductive outcomes of 52 women with classical bladder exstrophy.
This was an observational study with cross-sectional and retrospective arms.
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.
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.

    • "However, our study suggests that more females than males had an unfulfilled wish to have children. Deans et al. [17] described that 21% of their female patients conceived within 1 year after unprotected sexual intercourse, whereas the majority (79%) had delayed conceiving. Those 19 female patients had a total of 57 pregnancies, which resulted in 34 (56%) live births. "
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