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

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

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.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Catheters
  • Cystitis / etiology
  • Endometritis / drug therapy
  • Endometritis / etiology
  • Female
  • Fetal Death / etiology*
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Labor, Obstetric
  • Obstetric Labor Complications / diagnosis*
  • Pregnancy
  • Urinary Bladder / injuries*
  • Vagina / injuries*
  • Vaginal Discharge / drug therapy
  • Vaginal Discharge / etiology
  • Vesicovaginal Fistula / diagnosis
  • Vesicovaginal Fistula / etiology*

Substances

  • Anti-Bacterial Agents