ABSTRACT
Two cases of complex obstetric fistulae are reported. Poor assessment and mismanagement of labour were revealed. The resulting fistulae were vesico-urethro-rectovaginal and vesico-cervico-vaginal. Plastic repair using a modified Martius graft was used in case 1. Considering the young age of the patient, transplantation of the ureters into the rectum or colon was deemed undesirable. The patient's endurance over a period of ten years, with seventeen attempts at repair ultimately was rewarded by achieving both vesical and rectal continence. Repair using the transvaginal route was successful at the first attempt in case 2.
Subject(s)
Adult , Delivery, Obstetric/adverse effects , Female , Humans , Pregnancy , Plastic Surgery Procedures/methods , Rectovaginal Fistula/etiology , Reoperation , Vesicovaginal Fistula/etiologyABSTRACT
Massive ascites and hydrothorax as additional complications of pre-eclampsia are rare. The case reported is one of ascites and bilateral hydrothorax in a patient with severe pre-eclampsia. Careful antenatal assessment may help in detecting more cases with this complication, which is often misunderstood and the diagnosis missed.