Antenatal diagnosis of vesicouterine fistula.
BACKGROUND
In pregnancy, vesicouterine fistulas usually are diagnosed postpartum after cesarean deliveries.


METHODS
An 18-year-old woman, gravida 3, para 2, with two prior cesarean deliveries had pain and apparent rupture of membranes at 23 weeks' gestation. At 26 weeks' gestation, she developed increasing suprapubic pain and irregular contractions. Ultrasonographic findings included a small uterine defect and possible ballooning of membranes into her bladder. Cytoscopy showed ballooning of amnion into the bladder dome. A viable 900-g female infant was delivered by classic cesarean, the fistulous tract was excised, and the rupture sites were repaired.


CONCLUSIONS
Vesicouterine fistulas might be diagnosed antenatally. With continued contractions and associated uterine rupture, cesarean delivery can be done with excision of the fistulous tract and repair of the rupture sites.
Kennedy
C M
CM
Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City 52242, USA.
Peleg
D
D
Syrop
C
C
Nygaard
I
I
D000293:Adolescent; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D001747:Urinary Bladder Fistula / Q000000981:diagnostic imaging*; D014591:Uterine Diseases / Q000000981:diagnostic imaging*