title: Concomitant Vesicouterine Rupture with Avulsion of Ureter: A Rare Complication of Vaginal Birth after Cesarean Section.
abstract: Uterine rupture is the most serious and life threatening complication and occurs in 0.7-0.9% of vaginal birth after lower segment caesarean section. Cases of bladder rupture along with uterine rupture have been rarely reported and avulsion of ureter, required ureteric implantation is even rarer. This case report describe a very rare case of vesicouterine rupture with avulsion of ureter following vacuum assisted delivery in a grandmulti with previous lower segment cesarean section (LSCS). Haematuria is the most common presentation of bladder rupture. Antenatal counseling regarding this entity is recommended if woman opted for vaginal birth after cesarean section. Intrapartum and postpartum high index of suspicion are important in clinching the diagnosis.
authors.affiliation: Assistant Professor, Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
authors.forename: Nalini
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Senior resident, Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
authors.forename: J Lalnunnem
authors.initials: JL
authors.lastname: Thiek
authors.affiliation: Associate Professor, Department of Urology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
authors.forename: Stephen
authors.initials: S
authors.lastname: Sialo
authors.affiliation: Professor and Head Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
authors.forename: Santa Singh
authors.initials: SS
authors.lastname: Ahanthem
keywords: Bladder rupture; Haematuria; Uterine rupture