Share This Article:

Medication induced fetal bladder rupture: a case report

Abstract Full-Text HTML Download Download as PDF (Size:579KB) PP. 17-20
DOI: 10.4236/ojog.2011.12004    4,427 Downloads   8,221 Views   Citations

ABSTRACT

BACKGROUND: Intrauterine bladder rupture is a rare complication usually caused by structural bladder outlet obstruction. Some medications are known to cause urinary retention or diuresis in fetuses and preterm infants. CASE: A 31-year-old gravida 6, para 3023 at 29 weeks and 2 days’ gestation required intubation, mechanical ventilation, and medical management for severe chest pain and respiratory failure, eventually diagnosed as asthma and pneumonia. An obstetrical ultrasound on hospital day three revealed a markedly dilated fetal bladder. Repeat ultrasound the following day showed a decompressed fetal bladder and significant ascites. A cesarean delivery was performed for a nonreassuring fetal heart rate. Postnatal evaluation by voiding cystourethrogram and cystoscopy revealed bladder rupture without evidence of outlet obstruction. Given the absence of other plausible causes, the rupture was likely due to exposure to maternal medications. CONCLUSION: Transplacental exposure to maternal medications may cause fetal urinary retention and intrauterine bladder rupture. Fetal ultrasound surveillance during treatment with medications known to cause urinary retention may allow for early diagnosis and intervention.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Palmer, E. , Oliveros, M. , Fong, J. and Graham, G. (2011) Medication induced fetal bladder rupture: a case report. Open Journal of Obstetrics and Gynecology, 1, 17-20. doi: 10.4236/ojog.2011.12004.

References

[1] Okumo, S., Hamada, H., Fujiki, Y., Yasuoka, M., Watanabe, H., Yamada, N., Sohda, S. and Kubo, T. (1999) Transplacental exposure to antipsychotic drugs during pregnancy and megacystis in the fetus. Prenatal Diagnosis, 19, 980-982.
[2] Moises, E.C., de Barros Duarte, L., de Carvalho Cavalli, R., Lanchote, V.L., Duarte, G. and da Cunha, S.P. (2005) Pharmacokinetics and transplacental distribution of fentanyl in epidural anesthesia for normal pregnant women. European Journal of Clinical Pharmacology, 61, 517-522. doi:10.1007/s00228-005-0967-9
[3] Bengtsson, G.O., Wootton-Gorges, S.L., Poulain, F.R. and Sherman, M.P. (2003) Urinary effects of morphine in preterm infants. Acta Paediatrica, 92, 251-253. doi:10.1111/j.1651-2227.2003.tb00536.x
[4] Pras, E., Stienlauf, S., Pinkhas, J. and Sidi, Y. (1991) Urinary retention associated with ipratropium bromide. DICP, 25, 939-940.
[5] Bregante, M.A., Aramayona, J.J., Fraile, L.J., Garcia, M.A. and Solans, C. (2000) Diltiazem blood pharmacokinetics in the pregnant and nonpregnant rabbit: maternal and foetal tissue levels. Xenobiotica, 30, 831-841. doi:10.1080/00498250050119871
[6] Owens, G.R. and Tannenbaum, R. (1981) Theophylline-induced urinary retention. Annals of Internal Medicine, 94, 212-213.
[7] Omarini, D., Barzago, M.M., Bortolotti, A., Lucchini, G., Stellari, F., Enfrati, S. and Bonati, M. (1993) Placental transfer of theophylline in an in vitro closed perfusion system of human placenta isolated lobule. European Journal of Drug Metabolism and Pharmacokinetics, 18, 369-374.
[8] Wladimiroff, J.W. (1975) Effect of furosemide on fetal urine production. British Journal of Obstetrics and Gynecology, 82, 221-224. doi:10.1111/j.1471-0528.1975.tb00623.x

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.