10.1.3  Previously repaired fistula

You learned about fistula in Study Session 9. It is one of the most serious complications of obstructed labour and is highly prevalent in the rural areas of Ethiopia. If a woman developed a fistula during a previous labour, which was then surgically repaired, the scarring that developed as the fistula healed may have been so extensive that it obstructs the delivery of the next baby.

  • Which part of the birth canal will be scarred by a repaired fistula?

  • The vagina: a fistula is a torn opening between the vagina and either the urinary bladder, the rectum, the urethra or the ureter.

Important!Women who are known to have a scarred uterus, cervix or vagina should be strongly advised to deliver their next baby in a health facility with a blood transfusion service and the surgical equipment and expertise to perform a caesarean delivery if the need arises.

10.1.2  Scarred cervix

10.2  Why are multiparous women more at risk of uterine rupture?