Fistula in layman’s terms is a hole. Fistulae are abnormal conditions which cause abnormal connection to develop between two cavities. It’s an aberration which causes contents of different cavities to mix.

The female anatomy is made that the uterus lies above, with the bladder lying down and in front of the rectum.
Obstetric fistula is therefore a condition that results from the process of labour and causes the bladder, rectum or ureter to be abnormally connected to the vagina. This is usually called obstructed or prolonged labour.
A labour which fails to progress leading to the head of the baby being stuck in the birth canal is obstructed labour. This leads to stoppage of blood flow around that area causing necrosis as a result of continuous pressure exerted by the labour.
Fistulae can cause faecal and urine contents to be seen in the vagina.
The best thing to do when labour is obstructed is CS but here in Africa, our health systems do not usually cater for emergency medical procedures.

*EPIDEMIOLOGY *
?According to *WHO* *50,000-100,000* have this complications annually.
?In Freetown alone, *300* was recorded last year at Aberdeen Women Center.

*CAUSES*
?Pelvic fractures
?Previous abortion
?Cancer

*TREATMENT*
Via surgery

*CHALLENGES*
?Women not reporting for ANC.
?Traditional birth
?Professionals not readily available
?Procedure is relatively expensive.

*Derrick Ankrah*
*MJA-G*