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Vesicovaginal fistula formation after cervical cerclage mimicking premature rupture of membranes.

Wall LL, Khan F, Adams S

Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Washington University in St. Louis, Missouri 63110, USA. WALLL@wustl.edu

BACKGROUND: Women with a history of pregnancy loss in the second trimester are often diagnosed with cervical insufficiency and are treated with cervical cerclage. We present an unusual complication of this procedure that mimicked preterm rupture of membranes. CASE: A 38-year-old woman with a history of cervical conization, loss of a triplet pregnancy at 22 weeks, and one early spontaneous abortion underwent cervical cerclage placement during her third pregnancy. She developed an intermittent vesicovaginal fistula 2 weeks after the procedure that mimicked preterm premature rupture of membranes. Only after the urine loss became heavy and continuous 10 weeks later was the diagnosis of vesicovaginal fistula made. CONCLUSION: Obstetricians should recognize that cerclage placement may result in unusual urinary tract injury.

Published 1 February 2007 in Obstet Gynecol, 109(2): 493-4.
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