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Case Reports
. 2011 Feb;117(2 Pt 2):468-470.
doi: 10.1097/AOG.0b013e3181f9b749.

Transmural vaginal-to-bladder injury from an obstructed labor pattern

Arielle M Allen  1 , Tracy Lakin, S Abbas Shobeiri, Mikio Nihira
Affiliations
Case Reports

Transmural vaginal-to-bladder injury from an obstructed labor pattern

Arielle M Allen et al. Obstet Gynecol. 2011 Feb.

Abstract

Background: A vesicovaginal fistula, among other devastating sequelae, is a complication that can arise from obstetric trauma such as prolonged obstructed labor patterns. These are rarely seen as obstetric-related complications in well-developed countries. They are thought to arise from direct ischemic injury that can occur between the fetal head and the adjacent tissues.

Case: A patient presented to the emergency room in obstructed labor. Examination revealed a crowning fetal head, no fetal heart tones, and purulent vaginal discharge. Postpartum, the patient experienced irritative voiding symptoms, vaginal stenosis, and cystoscopic evidence of injury to the bladder base.

Conclusion: These findings may provide evidence of the transmural vaginal-to-bladder damage that can occur from obstructed labor.

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References

    1. Wall LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet 2006;368:1201–9.
    1. Arrowsmith S, Hamlin EC, Wall LL. Obstructed labor injury complex: obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing world. Obstet Gynecol Surv 1996;51:568–74.
    1. Ramphal S, Moodley J. Vesicovaginal fistula: obstetric causes. Curr Opin Obstet Gynecol 2006;18:147–51.
    1. Wittman AB, Wall LL. The evolutionary origins of obstructed labor: bipedalism, encephalization, and the human obstetric dilemma. Obstet Gynecol Surv 2007;62:739–48.

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