Successful pregnancy in patients with exstrophy-epispadias complex: A University of Washington experience

Women with EEC can have successful pregnancies, though at increased risk for preterm delivery and SABs. In our cohort, the rate of SAB is similar to that described in prior studies. Symptomatic UTIs likely due to self-catheterization were common. Cesarean delivery using a paramedian skin incision and classical uterine incision were not associated with major complications in this cohort. Limitations include reliance on retrospective data and small sample size. The strength of this study is the longitudinal detailed management of pregnancies in EEC women by a single team over time. A multidisciplinary approach to providing a continuum of care from pediatrics through adolescence to adulthood optimizes successful transitions, reproductive health, and successful pregnancies. Based on our experience, an algorithm providing guidance for pregnancy management was developed.Table. Pregnancy resulting in live birth versus spontaneous abortion or termination.Outcomes of 22 pregnancies in 12 EEC patientsOutcomeTotal pregnancies (n = 22)Bladder exstrophy pregnancies (n = 20)Cloacal exstrophy pregnancies (n = 2)Total pregnancies22 (100%)202Spontaneous abortion <24 weeks4 (18%)3 (15%)1 (50%)Terminations4 (18%)3 (15%)1 (50%)Live births14 (64%)14 (70%)0