Intractable Haematuria in Pregnancy: Challenges of Management Case Report and Review of Literature

Abstract

Background: Intractable haematuria is a life threatening and challenging urological emergency. It is more so when it occurs in pregnancy as the lives of both mother and baby are at risk. The safety in pregnancy of most agents or methods used in treatment of this condition is unknown.
Materials & methods: A 24 years old pregnant woman at 29 weeks gestation complained of total painless haematuria for days. Ultrasound scan revealed a bladder mass and a viable intrauterine gestation. She was admitted and managed with continuous saline irrigation of the bladder, and repeated blood transfusions as well as fetal monitoring. After 4 weeks, absent fetal heart tone was noticed. She went into spontaneous labour and was delivered of a fresh still born. She then had bladder irrigation with 1% alum solution. The bleeding stopped within 48 hours of treatment and she was discharged 72 hours later.
Conclusion: Intravesical alum irrigation is an effective method of treatment, its safety profile in pregnancy is unknown thus more studies in this regard are needed to prevent adverse maternal or perinatal outcomes.