Catastrophic Spontaneous Bladder Rupture In Late Puerperium

Abstract

Bladder necrosis after vaginal delivery is a rare but insidious occurrence. Bladder rupture during labor or postpartum is extremely rare. Patients usually complain of distension of the abdomen, suprapubic pain, anuria, or haematuria. Few patients may have no symptoms so the diagnosis of bladder rupture may be difficult in these situations. Bladder rupture is a challenge for obstetricians that should be diagnosed early and represents a surgical emergency.

We report a case of bladder rupture in a 29-year-old primigravida with gestational diabetes with fetal macrosomia which manifested late about 25^th days after full-term normal vaginal delivery. There was an intraperitoneal rupture of the bladder diagnosed by ascitic fluid typing revealing high levels of urea and creatinine in the fluid which was further confirmed by Computerised Tomography (CT) imaging. Our case report aims to focus on early diagnosis and timely management, which may lead to good prognostic outcomes and prevent maternal and fetal morbidity and mortality.