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Obstetric fistula (or vaginal fistula) is a medical condition in which a fistula (hole) develops between either the rectum and vagina (see rectovaginal fistula) or between the bladder and vagina (see vesicovaginal fistula) after severe or failed childbirth, when adequate medical care is not available. The United Nations Population Fund (UNFPA) defines obstetric fistula as,〔(【引用サイトリンク】title=When Pregnancy Harms: Obstetric Fistula )〕 “A childbirth injury that has been largely neglected, despite the devastating impact it has on the lives of affected girls and women. It is usually caused by prolonged, obstructed labour, without timely medical intervention—typically an emergency Caesarean section. During unassisted, prolonged, obstructed labour, the sustained pressure of the baby’s head on the mother’s pelvic bone damages soft tissues, creating a hole—or fistula—between the vagina and the bladder and/or rectum. The pressure deprives blood flow to the tissue, leading to necrosis. Eventually, the dead tissue comes away, leaving a fistula, which causes a constant leaking of urine and/or faeces through the vagina.” It is considered a disease of poverty because of its tendency to occur in women in poor countries who do not have health resources comparable to developed nations. An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year.〔http://www.unfpa.org/obstetric-fistula〕〔https://www.fascrs.org/core-subject/rectovaginal-fistula-and-rectourethral-fistula〕〔Browning, Andrew. "Obstetric Fistula In Ilorin, Nigeria." Plos Medicine 1.1 (2004): 022-024. Academic Search Complete. Web. 25 Oct. 2012.〕 In developed countries, the majority of women with OF suffer rectovaginal fistula (RVF). This is caused by episiotomy and forceps/vacuum extraction of the baby from the vagina. Over 80% of RVFs in the USA are obstetric, followed by Crohn's and radiation.〔http://www.fascrs.org/core-subject/rectovaginal-fistula-and-rectourethral-fistula〕 A fistula is almost entirely preventable. According to health advocates, its persistence is a sign that health systems are failing to meet women’s essential needs.〔 ==Signs and symptoms== Symptoms of obstetric fistula include: * Flatulence, urinary or fecal incontinence, which may be continual or only happen at night〔"Women's Health." Vaginal Fistula Causes, Symptoms, & Treatments. WebMD, n.d. Web. 22 Oct. 2012. * Foul-smelling vaginal discharge〔〔〔"Rectovaginal Fistula." Mayo Clinic. Mayo Foundation for Medical Education and Research, 29 May 2010. Web. 22 Oct. 2012. * Repeated vaginal or urinary tract infections〔〔 * Irritation or pain in the vagina or surrounding areas〔〔Wong M, Ozel B (2010). Fistulae. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 328-332. Chichester: Wiley-Blackwell.〕 * Pain during sexual activity〔〔〔 Other effects of obstetric fistulae include stillborn babies due to prolonged labor, which happens 85% to 100% of the time,〔〔Ahmed, S., & Holtz, S.A. (2007). Social and economic consequences of obstetric fistula: Life changes forever? International Journal of Gyne - cology & Obstetrics, 99, S10-S15.〕〔Zheng, A.X., & Anderson, F.W. (2009). Obstetric fistula in low-income countries. International Journal of Gynecology & Obstetrics, 104(2), 85- 89.〕 severe ulcerations of the vaginal tract, "foot drop", which is the paralysis of the lower limbs caused by nerve damage, making it impossible for women to walk,〔〔 infection of the fistula forming an abscess,〔 and up to two-thirds of the women become amenorrhoeic.〔 Obstetric fistulae have far-reaching physical, social, economic, and psychological consequences for the women affected. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Obstetric fistula」の詳細全文を読む スポンサード リンク
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