Abstract
We present a case in which simultaneous uterine and bladder rupture occurred at 41 and 4/7 weeks' gestation in the fourth pregnancy in a woman who had previously delivered operatively. Factors precipitating the uterine rupture include previous Cesarean section with oxytocin enhancement of labor [1]. Bladder-uterine adhesions with bladder distension led to the concomitant bladder rupture. Principles of treatment are discussed. Although an unusual presentation of spontaneous bladder rupture, an understanding of the risk factors involved, along with an appropriate protocol for surgical management, should be part of the working knowledge of every gynecologist and urologist.
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Schinsky DC, Benson RC. Rupture of the pregnant uterus: a review. Obstet Gynecol Surg 1978; 33:217–232
Niebyl JR, Simpson JL. Obstetrics, normal and problem pregnancies, Ortho Forum, New York, Churchill Livingstone, p. 530
Nielsen TF, Ljungblad U, Hagberg H. Rupture and dehiscence of Cesarean section scar during pregnancy and delivery. Am J Obstet Gynecol 1989; 160:569–573
Novas J, Myers SA, Gleicher N. Obstetric outcome of patients with more than one previous Cesarean section. Am J Obstet Gynecol 1989; 160:364–367
Mootabar H, Dwyer JF, Surer F. Vaginal delivery following previous Cesarean section in 1983. Int J Gynecol Obstet 1984; 22:155–160
Plauche WC, von Almen W, Muller R. Catastrophic uterine rupture Obstet Gynecol 1984; 64:792–797
Mullings AMA, Hall J. Rupture of uterus and bladder in vaginal delivery following previous Cesarean section. W I Med J 1987; 36:51–53
Peters PC. Intraperitoneal rupture of the bladder. In: Urologic clinics of North America Philadelphia: WB Saunders, 1989: Vol 16 p 279–282
McElin TW, Bird CC, Reeves BD. Study of uterine perforation occurring during 2991 instances of diagnostic curettage. Int J Gynecol Obstet 1969; 7:243
Golan A, Sandbank O, Rubin A. Rupture of the pregnant uterus. Obstet Gynecol 1980; 56:549–554
Paul RH. Fetal heart rate and uterine activity monitoring: what every practitioner must know about the equipment. In: Mishell DR, Brenner PF, eds. Management of common problems in obstetrics and gynecology. 2nd edn. New Jersey: Medical Economics Company, Inc., 1988: 228–233
Clinical Dialogue p. 2 Wein AJ, and Elkins TE. In: Clinical dialogue in female urology, urinary fistulas: the diagnostic evaluation & repair of the vesicovaginal fistula. Illustrated Medicine, Vol. 1, 1990, p2
CIB A p145. The CIBA collection of medical illustrations, Vol. 2, Prepared by Frank H. Netter. Edited by Ernst Oppenheimer, MD, CIBA, p145
Rodriguez MH, Masaki DI, Phelan JP, Diaz FG. Uterine rupture: are intrauterine pressure catheters useful in the diagnosis? Am J Obset Gynecol 1989; 161:668–669
Rahman J, Al-Sibai MH, Rahman MS. Rupture of the uterus in labor: a review of 96 cases. Acta Obstet Gynecol Scand 1985; 64:311–315
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Klutke, J.J., Klutke, C.G. Simultaneous bladder and uterine rupture at the time of attempted vaginal birth after Cesarean section. Int Urogynecol J 3, 83–86 (1992). https://doi.org/10.1007/BF00372663
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DOI: https://doi.org/10.1007/BF00372663