Prenatal diagnosis of bladder exstrophy by fetal MRI

Goldman, S; Szejnfeld, Patricia Oliveira; Rondon, Atila; Francisco, Viviane Vieira; Bacelar, Herick; Leslie, Bruno; Barroso, Ubirajara; Ortiz, Valdemar; Macedo, António

doi:10.1016/j.jpurol.2012.06.018

Cited by 27 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prenatal diagnosis gives the parents an opportunity to determine whether to continue the pregnancy or not, because the long-term results in boys always ends up with sexual dysfunction [10]. Ultrasound and magnetic resonance imaging (MRI) have been found to be a good method to diagnose ectopia vesicae [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Repeated successful vaginal delivery in a pregnant woman with unrepaired ectopia vesicae and split pelvis: a case study

Liu

Song

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Ectopia vesicae, or bladder exstrophy, is a rare malformation, more frequently found in males. Very few cases of pregnancy with unrepaired ectopia vesicae have been reported in literature. The majority of these pregnant women with ectopia vesicae have terminated their pregnancies by cesarean section due to malpresentation, preterm labor or other indications. Clemetson concluded that cesarean section was the preferable method of term delivery to avoid postpartum prolapse. We have a different opinion on this because we had an interesting case. A woman with unrepaired ectopia vesicae had two successful vaginal deliveries, in 2009 and 2019 respectively. She recovered well and did not have any symptoms or signs of pelvic organ prolapse (POP) so far. Case presentation: Let us present this woman with ectopia vesicae who had four pregnancies; two spontaneous abortions and two vaginal deliveries. In 2009, she had a successful vaginal delivery at Yantai Harbor Hospital where the first author worked at that time. She met the first author again surprisingly, during her third trimester in 2019. She had a spacious pelvis and pendulous abdomen. In this fourth pregnancy, the fetus changed its presentation frequently. Still, she had the second vaginal delivery successfully. She recovered fully after delivery and did not have any symptoms or signs of POP. As far as we know, this is the first case that a patient with ectopia vesicae who has been observed for such a long time after multiple vaginal deliveries. Conclusions: Doctors must evaluate the risk of vaginal delivery or cesarean section and consider maternal-neonatal health. Prior to this, women with repaired or unrepaired ectopia vesicae usually delivered their babies by cesarean section. Our practice shows that vaginal delivery is also a safe and feasible choice for some of these patients, especially for those with unrepaired, mild types of ectopia vesicae who experience no other dangerous or uncomfortable symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Repeated successful vaginal delivery in a pregnant woman with unrepaired ectopia vesicae and split pelvis: a case study

Liu

Song

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…When prenatal ultrasonography suspects BE but does not detect a lower abdominal mass, it is recommended to perform fetal MRI to assist the diagnosis. MRI can effectively identify ureteral and bladder wall abnormalities without possible interference by maternal body habitus, amniotic uid volume and fetal position [30] .…”

Section: How To Diagnose Single Umbilical Artery Combined With Bladde...mentioning

confidence: 99%

A Case Report of Single Umbilical Artery Combined with Fetal Bladder Exstrophy in Singleton Pregnancy and Related Literature Review

Zhan

Jia

Gao

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Single umbilical artery is the most common umbilical cord dysplasia. According to prenatal ultrasonographic studies, single umbilical artery may be present alone or in association with other fetal abnormalities. The current mainstream theories about the mechanism of single umbilical artery leading to abnormal fetal development are the theories of “vitelline vascular steal” and “disturbance of embryo caudal development”. In addition, bladder exstrophy is mainly characterized by the exposure to bladder mucosa. So far, the exact pathogenesis of bladder exstrophy is unclear. The bladder is a part of the cloaca; thus, some scholars believe that bladder exstrophy and cloacal exstrophy should be regarded as a disease spectrum for research. These scholars believe that both cloacal exstrophy and bladder exstrophy belong to cloacal dysplasia, therefore these two diseases should be included in the same disease spectrum in order to explore their pathogenesis. Previous literatures have reported that single umbilical artery is associated with cloacal exstrophy. If bladder exstrophy and cloacal exstrophy are regarded as the same disease spectrum, then we can speculate that the single umbilical artery should have the probability of being accompanied by bladder exstrophy at the same time. However, as of now, there are no reports of bladder exstrophy associated with single umbilical artery in singleton pregnancy. Case presentation: For the first time, we report a rare case of fetal bladder exstrophy with single umbilical artery in single pregnancy. This patient underwent targeted color Doppler ultrasound and fetal MRI for diagnosis. After the diagnosis was confirmed, the patient was scheduled for a multidisciplinary discussion. Ultimately the patient opted for induced fetal demise. Conclusions Our report is the first finding of single umbilical artery combined with bladder exstrophy in a singleton pregnancy. Accordingly, our case enhances the evidence that cloacal exstrophy and bladder exstrophy should be treated as the same disease spectrum, and it adds to the richness of the disease spectrum caused by single umbilical artery. In addition, we conducted a literature review on the diagnostic progress of single umbilical artery combined with bladder exstrophy, hoping to provide useful references for the diagnosis of this disease.

show abstract

“…4 Fetal MRI can provide more detailed anatomy of the defect with accurate sexual differentiation. 6,7 Inguinal hernia is a common association with this entity which can present anytime between birth and adulthood. 8 Hernia is more often bilateral, more common in male and has a tendency to recur even after surgical correction.…”

Section: Introductionmentioning

confidence: 99%

Bladder exstrophy with inguinal hernia: a case report

Ansari

Gandhi

Wade

et al. 2020

Int J Contemp Pediatr

View full text Add to dashboard Cite

Exstrophy of urinary bladder with epispadias involves protrusion of the urinary bladder through a defect in the lower abdominal wall accompanied by separation of pubic symphysis. It is a rare but challenging condition that causes significant physical, functional, social, sexual and psychological problems later in life. Bladder exstrophy commonly involves males and most cases are sporadic. Inguinal hernia is a complication associated with bladder exstrophy and it occurs due to lack of obliquity of the inguinal canal secondary to pubic diastasis. Authors report here, a case of antenatally diagnosed case of classic bladder exstrophy associated with left sided inguinal hernia which was incidentally diagnosed on tenth day of life. Our neonate underwent primary bladder closure with herniotomy. Staged reconstruction of epispadias and bladder neck has been planned at a later date. Recurrence of inguinal hernia after repair is common and bilateral inguinal exploration while performing herniotomy is advised to prevent its recurrence. Prognosis of such cases depends on the degree of continence achieved. With timely reconstructive surgery, continence rates can be as high as 60-70 percent.

show abstract

Prenatal diagnosis of bladder exstrophy by fetal MRI

Abstract: The MRI showed a detailed scenario of the abnormality with advantages over the US evaluation in regard to excluding cloacal anomalies. MRI allowed accurate sexual differentiation and may be indicated after suspected bladder exstrophy on US evaluation.

Cited by 27 publications

References 12 publications

Repeated successful vaginal delivery in a pregnant woman with unrepaired ectopia vesicae and split pelvis: a case study

Repeated successful vaginal delivery in a pregnant woman with unrepaired ectopia vesicae and split pelvis: a case study

A Case Report of Single Umbilical Artery Combined with Fetal Bladder Exstrophy in Singleton Pregnancy and Related Literature Review

Bladder exstrophy with inguinal hernia: a case report

Contact Info

Product

Resources

About