Management of severe hemorrhagic cystitis in pregnancy. A report of two cases.

Acute hemorrhagic cystitis (AHC) is gross hematuria and symptoms of cystitis. Usually a self-limiting entity, it is found mainly in children and cancer patients receiving chemotherapy or radiation. In a small number of patients, AHC can be severe and require aggressive management. We present two cases of severe acute hemorrhagic cystitis in pregnant women that led to hemorrhage, resistance to antibiotic therapy and premature labor. Continuous bladder irrigation with normal saline was attempted with success in stopping the hematuria and arresting the premature labor. Severe hemorrhagic cystitis in pregnancy may require aggressive management when associated with a significant blood loss and preterm labor.