Missed bladder rupture following vaginal delivery: Possible role of assessing ascitic fluid creatinine levels?

Abstract

Bladder injury is the most common urological trauma following the gynecological procedure. Normal vaginal delivery candidates with unresponsive and prolonged ascites and bladder‐emptying complaints should be examined for bladder rupture. We also suggest measurement of ascitic fluid creatinine levels in these patients.

A rare cause of acute abdomen: Spontaneous bladder rupture following normal vaginal delivery

“…Serum creatinine and urea will rise in 100% of patients after 24 hours of bladder rupture, and urinary ascites should be suspected when the analysis of fluid shows higher creatinine or urea than the serum with a ratio of ascitic fluid to serum creatinine that is greater than one and the high serum ascites albumin gradient. Urinary ascites will lead to equilibration of urine and plasma through a peritoneal membrane that causes pseudo-kidney injury pattern, including elevated serum creatinine levels, hyponatremia, hyperkalemia, and azotemia which justify the abnormal laboratory markers of our patient (4,6,7).…”

Massive ascites following spontaneous vaginal delivery in a woman with preeclampsia-a diagnostic and management challenges in a low resource country: A case report

“…Ascites is reported antenatally, after normal delivery and after cesarean section in the postpartum period, as well as during cesarean section in women with preeclampsia [ [4] , [5] , [6] , 8 , 9 ]. There are case reports of postpartum ascites caused by bladder rupture following vaginal delivery [ 10 ], tuberculosis peritonitis [ 11 ], idiopathic chylous ascites [ 12 ], pregnancy specific liver disease [ 13 ], lupus peritonitis [ 14 ], etc. In women who are diagnosed to have ascites in the postpartum period, it is important to rule out other possible causes of ascites through proper history and examination, and necessary investigations.…”

Spontaneous bladder rupture after non-traumatic vaginal delivery: a rare case report

“…Usually, SRB occurs following a bladder damage (from malignant diseases, acute or chronic urinary distension, obstructive pathology, chronic infection, necrotizing or post-radiation cystitis) or bladder trauma or a combination of the two [ 3 , 4 ]. The occurrence of peri-partum SRB has been reported in the literature and generally was associated with an obstructed labor or a scarred uterus [ 5 ].…”