回腸利用膀胱拡大術施行後に出産した二分脊椎患者

Pregnancy and delivery in a patient with augmentation ileocystoplasty

29歳女性，妊娠6週。患者は二分脊椎に伴う神経因性膀胱に対し，14歳時に回腸利用膀胱拡大術を施行されていた。当院での出産を希望し，妊娠中および周産期の尿路管理を目的として当科に紹介となる。患者は妊娠18週に急性腎盂腎炎を発症し，妊娠38週で潜在性胎児仮死の診断で緊急帝王切開に至った。膀胱拡大術後の妊娠・出産には，産婦人科医と連携し，泌尿器科医も積極的に関わる必要があると思われた。

A 29-year-old woman with a history of spina bifida became pregnant after ileocystoplasty for her neurogenic bladder at the age of 14. She was introduced to our department for urological management during pregnancy and delivery,and a 18 weeks,she developed pyelonephritis. At 38 weeks,urgent cesarean section was performed for latent fetal distress. Close cooperation with obstetricians,and urologists is mandatory during the pregnancy and delivery in the patient with augmentation cystoplasty.