Anatom3D
ENCZDE
Download

Obstructed labour and obstetric fistula

Partus impeditus; fistula vesicovaginalis · Zastavený porod a porodnická píštěl

female only

What it is

The baby cannot pass through the pelvis; without caesarean, days of pressure kill the tissue and leave a hole from the vagina into the bladder or rectum. Over half a million women live with fistula.

Symptoms & signs

  • Labour that does not progress despite strong contractions
  • exhaustion, fever, dehydration
  • womb rupture: sudden pain, contractions stop
  • baby usually stillborn
  • afterwards constant leaking of urine or stool from the vagina
  • foot drop
  • smell, shame and social exclusion

🚩 Get help if…

  • call 112 / 911 now Labour over 12 hours with no progress, or pushing over 1 hour without birth
  • call 112 / 911 now Constant severe pain, bleeding or contractions that suddenly stop
  • call 112 / 911 now Fever, foul discharge or the baby moving less in labour
  • see a doctor soon Leaking urine or stool from the vagina after birth

Where it strikes

Medical treatment

  • Partograph to spot stalled labour
  • caesarean or assisted birth when labour is obstructed
  • bladder catheter for weeks after a prolonged labour — small fresh fistulas may close (weak evidence)
  • surgical repair by a trained fistula surgeon — about 85–90% close at the first operation, though some still leak
  • repair of womb rupture, antibiotics and fluids

Natural & lifestyle

  • Physiotherapy for foot drop and the pelvic floor
  • nutrition, counselling and return to the community
  • first pregnancy after adolescence — education for girls, no child marriage

Emerging & experimental

  • Task-sharing of caesarean to trained non-physicians — outcomes comparable in studies
  • slings and bulking for leaking after closure
  • tissue-engineered grafts

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Traditional cuts of the vagina (gishiri) to ease labour — cause fistulas; harmful anecdotal / traditional
  • Herbal remedies to close a fistula — none work; surgery is needed anecdotal / traditional

ICD codes