Fetal Bladder Rupture as a Complication of Adjunctive Therapy in Severe Maternal SARS-CoV-2 Pneumonia. (3rd September 2022)

• Record Type: Journal Article
• Authors: Gutierrez, Jorge; Sepulveda, Waldo; Ramirez, Raul; Acosta, Gina; Ambiado, Sergio
• Is Part Of: Fetal and pediatric pathology. Volume 41:Number 5(2022)
• Page Start: 818
• Page End: 822
• Publication Date: 2022-09-03
• Subjects: COVID-19 -- fetal bladder rupture -- prenatal diagnosis -- SARS-CoV-2 pneumonia; Pathology, Molecular -- Periodicals; Pediatrics -- Periodicals; Molecular biology -- Periodicals; Pediatric pathology -- Periodicals; Fetal Diseases -- pathology -- Periodicals; Infant, Newborn, Diseases -- pathology -- Periodicals; Pediatrics -- Periodicals; 618.92007
• DOI: 10.1080/15513815.2021.1963359
• Languages: English
• ISSNs: 1551-3815

Abstract

Abstract: Introduction: A case of spontaneous fetal bladder rupture occurring in a woman with SARS-CoV-2 pneumonia receiving invasive ventilatory support is reported. Case: A 33-year-old woman was admitted at 30.6 weeks' gestation with the diagnosis of severe pneumonia due to COVID-19. The patient required invasive mechanical ventilation on day 2. Propofol, fentanyl, midazolam, and dexmedetomidine were administered for sedation, pain relief, and to improve patient-ventilator interaction. A bedside ultrasound on day 3 revealed fetal megacystis. Follow-up scan two days later showed urinary ascites and a collapsed bladder. The diagnosis of fetal bladder rupture was confirmed postpartum. Bladder repair was performed on day 5, with an uneventful recovery. Discussion: Transplacental transfer of opioids during invasive ventilatory support in pregnancy may cause acute fetal bladder atony leading to severe urine retention and, potentially, bladder rupture. This can be a serious complication of adjunctive therapy in women with severe SARS-CoV-2 pneumonia.