title: Reproductive outcomes in women with classic bladder exstrophy: an observational cross-sectional study.
abstract: OBJECTIVE
  We sought to examine the reproductive outcomes of 52 women with classical bladder exstrophy.
  
  
  METHODS
  This was an observational study with cross-sectional and retrospective arms.
  
  
  RESULTS
  The average age of the sample was 33 years (range, 17-63). Of those who had tried, 19/38 (66%) had conceived. A total of 57 pregnancies (3 sets of twins) were reported for the 19 patients and resulted in 34/57 live births (56%), 21/57 miscarriages (35%), 1/57 (2%) termination, and 4/57 (7%) stillbirths or neonatal deaths. Four deliveries resulted in major complications including 1 transection of the ureter (4%), 1 fistula formation (4%), and 2 postpartum hemorrhages (8%). There were 2 admissions to intensive care, one for urinary sepsis and another for massive obstetric hemorrhage.
  
  
  CONCLUSIONS
  Fertility is impaired in women with bladder exstrophy. Pregnancy is high risk both for the mother and baby. Delivery should be at a tertiary referral obstetric unit with urology cover. In the majority of cases planned cesarean section is the most appropriate mode of delivery.
authors.affiliation: Royal Hospital for Women and University of New South Wales, Sydney, NSW, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Deans
authors.forename: Frederick
authors.initials: F
authors.lastname: Banks
authors.forename: Lih-Mei
authors.initials: LM
authors.lastname: Liao
authors.forename: Dan
authors.initials: D
authors.lastname: Wood
authors.forename: Christopher
authors.initials: C
authors.lastname: Woodhouse
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Creighton
mesh_terms: D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000150:complications* / Q000601:surgery; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005306:Fertilization; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult