title: Vaginal Delivery After Dührssen Incisions in a Patient With Bladder Exstrophy and Uterine Prolapse.
abstract: Bladder exstrophy is a rare congenital anomaly affecting the lower abdominal wall, pelvis, and genitourinary structures. Pregnant women with bladder exstrophy present a unique challenge to the obstetrician.
  
  
  
  The patient is a 35-year old pregnant woman with bladder exstrophy, an extensive surgical history, and uterine prolapse with an abnormal, rubbery consistency to her cervix. Prenatally, she was counseled on the potential use of Dührssen incisions to facilitate vaginal delivery. Labor was induced at 36 4/7 weeks of gestation after her pregnancy was complicated by recurrent pyelonephritis. Vaginal delivery was achieved 8 minutes after the creation of Dührssen incisions.
  
  
  
  The care of pregnant women with bladder exstrophy requires multidisciplinary management and careful delivery planning. Successful vaginal delivery can be attained in these patients.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Southern California, Los Angeles, California.
authors.forename: Ruben
authors.initials: R
authors.lastname: Lachica
authors.forename: Yen
authors.initials: Y
authors.lastname: Chan
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Uquillas
authors.forename: Richard H
authors.initials: RH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001746:Bladder Exstrophy / Q000150:complications / Q000503:physiopathology; D002584:Cervix Uteri / Q000503:physiopathology / Q000601:surgery*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D010347:Patient Care Planning; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011256:Pregnancy Outcome; D019651:Plastic Surgery Procedures / Q000379:methods; D020379:Risk Adjustment; D002577:Uterine Cervical Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014596:Uterine Prolapse / Q000209:etiology / Q000503:physiopathology