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To prevent any new cases of obstetric fistulae, about 75,000 new emergency obstetric care facilities would have to be built in Africa alone, [59] plus an increase in financial support and an even higher number of certified doctors, midwives, and nurses needed. Another challenge standing between women and fistula treatment is information.
Rectovaginal fistulas are often the result of trauma during childbirth (in which case it is known as obstetric fistula), with increased risk associated with significant lacerations or interventions are used such as episiotomy or operative (forceps/vacuum extraction) deliveries [2] or in situations where there is inadequate health care, such as in some developing countries.
The treatment of obstructed labour may require cesarean section or vacuum extraction with possible surgical opening of the symphysis pubis. [4] Caesarean section is an invasive method but is often the only method that will save the lives of both the mother and the infant. [18] Symphysiotomy is the surgical opening of the symphysis pubis.
Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. [citation needed] In addition to the medical sequela from these fistulas, they often have a profound effect on the patient's emotional well-being.
A ureterovaginal fistula is a result of trauma, infection, pelvic surgery, radiation treatment and therapy, malignancy, or inflammatory bowel disease. Symptoms can be troubling for women especially since some clinicians delay treatment until inflammation is reduced and stronger tissue has formed. [2]
Abnormal passage of stool through the vagina is caused by a rectovaginal fistula. [15] Treatment is often surgical with the use of tissue grafts. [15] [16] The presence of bowel disease increases the risk of a rectovaginal fistula. [15] An entero-vaginal fistula can form between the bowel and the vagina. [17]
Watchful waiting is the treatment of choice in case of small fistulas. The bladder is catheterised for a period of 4 to 8 weeks in order to allow spontaneous closure of the vesicouterine fistula. Fulguration of the fistula can also be done via cystoscopy in cases of small fistulas. [2]
A uterotonic, also known as an oxytocic or ecbolic, is a type of medication used to induce contraction or greater tonicity of the uterus. Uterotonics are used both to induce labor and to reduce postpartum hemorrhage. [1] Labor induction in the third trimester of pregnancy may be