Fetal limb in bladder: A rare complication of vesicouterine fistula

ABSTRACT

Vesicouterine fistula (VUF) is a rare urogenital fistula that is even rarer during pregnancy. Even if pregnancy occurs, the outcomes appear to be very poor. The most of the cases are related to iatrogenic bladder injury during cesarean section. There is very limited literature on the pregnancy with VUF associated with herniation of fetus or fetal part(s) into the bladder cavity. Here, we report a case of pregnancy in a known case of untreated VUF. She presented at 23 weeks of gestation with features of premature rupture of membrane and herniation of fetal left lower limb inside the bladder cavity. Her pregnancy ended up with hysterotomy and the removal of a non-viable fetus along with the repair of the fistula. Hence, regardless of the severity of the signs and symptoms associated with VUF, clinicians should convince the patients for the repair of the fistula especially if the future pregnancy is contemplated