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Title: PATENT URACHAL FISTULA IN A PREGNANT FEMALE-A RARE CASE REPORT
e-poster Number: EP 149
Category: Maternal and Fetal Health
Author Name: Dr. Rana Ishita Samarpal
Institute: J.J.M MEDICAL COLLEGE ,DAVANGERE,KARNATAKA
Co-Author Name:
Abstract :
PATENT URACHAL FISTULA IN A PREGNANT FEMALE-A RARE CASE REPORT INTRODUCTION: The term patent urachal fistula describes an abnormality of the umbilical cord that arises when normal embryologic tissue that connects the developing bladder to the umbilical cord fails to involute. AIMS AND OBJECTIVES: This poster presents a review of the clinical features, diagnostic approaches and management of patent urachal fistula in a pregnant female MATERIALS AND METHODS: 24-year-old primigravida with 35 weeks of gestation came with complaints of watery discharge on and off from her umbilicus in the last 3 months.Clear fluid drained from umbilicus with ammonical odor on performing midline compression of the lower abdomen.On ultrasound and MRI T2 Saggital section evidencing bladder compression by the gravid uterus with the hyperintensity of bladder seen tracking and extending till the umbilicus, s/o a connection between the bladder and umbilicus in the subcutaneous plane i.e patent urachal fistula. RESULTS: Pregnancy was continued till term and was planned for normal vaginal delivery after consulting the urologist.In case of any difficulty in vaginal delivery cesarean section was planned along with removal of fistula by urologist.Antibiotic coverage was given.Patient delivered vaginally a single live term male baby without any complications. Urologist suggested removal of the patent urachus in its entirety, including the portion of the bladder it attaches to by laproscopic/open approach after 6 months as it can lead to malignancy in 50% cases. CONCLUSION: Urachal anomalies are a rare entity seen in only 1 per 5000 live births with a male preponderance of 3:1.Of the overall urachal anomalies patent urachus is seen in only 1%.Meticulous handling of such rare cases is required .Therefore,an accurate assessment of the characteristics of the urachal abnormality,location, correct imaging and management in pregnancy with multidisciplinary approach is crucial for the better outcome of mother and her newborn.
