Obstetrical fistula
| Obstetric fistula | |
|---|---|
 |
|
| Areas where obstetric fistulae commonly occur | |
| Classification and external resources | |
| Specialty | urology |
| ICD-10 | N82 |
| ICD-9-CM | 619 |
| MeSH | D014624 |
Obstetric fistula is a medical condition in which a fistula (hole) develops between either the rectum and vagina (see rectovaginal fistula), a ureter and the vagina, or between the bladder and vagina (see vesicovaginal fistula) after prolonged, severe or failed childbirth. Though uncommon where emergency care is available for women in labor, it is more prevalent when adequate medical care is not available. It results in incontinence. The United Nations Population Fund (UNFPA) defines obstetric fistula as,
“A childbirth injury that has been largely neglected, despite the devastating impact it has on the lives of affected girls and women. It is usually caused by prolonged, obstructed labour, without timely medical intervention—typically an emergency Caesarean section. During unassisted, prolonged, obstructed labour, the sustained pressure of the baby’s head on the mother’s pelvic bone damages soft tissues, creating a hole—or fistula—between the vagina and the bladder and/or rectum. The pressure deprives blood flow to the tissue, leading to necrosis. Eventually, the dead tissue comes away, leaving a fistula, which causes a constant leaking of urine and/or faeces through the vagina.”
It is considered a disease of poverty or injury because of its tendency to occur in women in poor countries who do not have access to adequate obstetrics care.8 An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year.
In developed countries, the majority of women with OF suffer rectovaginal fistula (RVF). This injury is associated with episiotomy and forceps/vacuum extraction of the baby from the vagina. Over 80% of RVFs in the USA are obstetric and either preventable or treatable, followed in frequency by Crohn's disease and radiation.
An obstetric fistula is almost entirely preventable. According to health advocates, its persistence is a sign that health systems are failing to meet women’s essential needs.
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Wikipedia