Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Oct 9:44:e00654.
doi: 10.1016/j.crwh.2024.e00654. eCollection 2024 Dec.

Optimizing cesarean delivery in a patient with exstrophy-epispadias via prenatal MRI and surgical planning: A case report

Jamie Michael  1 , Hebron Kelecha  2 , Diana Bowen  1   3 , Amber Watters  2
Affiliations
Case Reports

Optimizing cesarean delivery in a patient with exstrophy-epispadias via prenatal MRI and surgical planning: A case report

Jamie Michael et al. Case Rep Womens Health. .

Abstract

Due to advancements in medical care and reconstructive surgery, more patients with bladder exstrophy are reaching reproductive age and considering pregnancy. Complications are more common during pregnancy in this patient population, given medical comorbidities and prior surgical intervention. In the case of cesarean delivery, careful planning is necessary to prevent inadvertent injury to the bladder or bowel segments. This report concerns a patient with a history of infant closure of bladder exstrophy, followed by two bladder augmentations and a catheterizable channel who presented for care at 9 weeks of gestation. Magnetic resonance imaging (MRI) at 36 weeks of gestation was used to delineate the anatomy in planning for cesarean delivery. The patient underwent a successful cesarean delivery at 38 weeks 1 day of gestation. Patients with prior urologic reconstruction can undergo safe cesarean delivery if proper surgical planning is performed. Multidisciplinary care and prenatal MRI are valuable tools for avoiding surgical complications.

Keywords: Cesarean section; Congenital anomalies; Radiology.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
MRI scan identifying the channel traversing the right lower quadrant.
Fig. 2
Fig. 2
MRI scan showing an augment in the right upper quadrant.
Fig. 3
Fig. 3
Photograph of the patient's abdomen on the day of cesarean delivery.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Gambhir L., et al. Epidemiological survey of 214 families with bladder exstrophy-epispadias complex. J. Urol. 2008;179(4):1539–1543. - PMC - PubMed
    1. Bhatnagar V., et al. Augmentation colocystoplasty in bladder exstrophy. Pediatr. Surg. Int. 2002;18(1):43–49. - PubMed
    1. Dy G.W., et al. Successful pregnancy in patients with exstrophy-epispadias complex: a University of Washington experience. J. Pediatr. Urol. 2015;11(4) 213 e1-6. - PubMed
    1. Huck N., et al. Pregnancy following urinary tract reconstruction using bowel segments: a review of published literature. World. J. Urol. 2020;38(2):335–342. - PubMed
    1. Gnade Colette, Kowalski Joseph T., Andrews Janet I., Anaya Heather. Management of pregnancy in patients with exstrophy-epispadias sequence: a case series and literature review. Proc. Obstet. Gynecol. 2018;8(1):1.

Publication types

LinkOut - more resources