Obstetrics and Gynecology - A. M. Gromova 2000

Birth Injuries
Postpartum Fistulae

Pathological labor may lead to The Development of urogenital and rectovaginal fistulas. Urogenital fistulas are abnormal tracts connecting the Urinary Bladder or Urethra with the Vagina. In such cases, urine partially or completely enters the vagina and leaks outward through the pudendal cleft. With rectovaginal fistulas, fecal matter enters the vagina.

Fistulas develop As a result of prolonged compression of the soft Tissues of the birth canal and adjacent Organs between the pelvic walls and the fetal presenting part. This compression causes circulatory impairment followed by tissue necrosis. Once the necrotic areas slough off, urine or feces begin to penetrate the vagina, typically on the 5th to 7th day postpartum. Fistulas may also arise from traumatic injury to the soft tissues of the birth canal and adjacent organs (the urinary bladder or rectum) caused by instruments used in obstetric interventions (destructive Procedures, forceps, etc.). In such cases, the fistula appears immediately after delivery.

The Prevention of fistulas relies on the proper Management of Labor. If the fetal HEAD remains arrested for 2–3 hours at the pelvic inlet, cavity, or outlet, a vaginal examination must be performed to clarify the Diagnosis and determine the appropriate method of delivery. Treatment for fistulas is surgical, performed 3–4 months postpartum.



Last update: 08/08/2026

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