Simultaneous bladder and uterine rupture at the time of attempted vaginal birth after Cesarean section

Abstract

We present a case in which simultaneous uterine and bladder rupture occurred at 41 and 4/7 weeks' gestation in the fourth pregnancy in a woman who had previously delivered operatively. Factors precipitating the uterine rupture include previous Cesarean section with oxytocin enhancement of labor [1]. Bladder-uterine adhesions with bladder distension led to the concomitant bladder rupture. Principles of treatment are discussed. Although an unusual presentation of spontaneous bladder rupture, an understanding of the risk factors involved, along with an appropriate protocol for surgical management, should be part of the working knowledge of every gynecologist and urologist.