Korell Allison N, Argenta Peter A, Strathy Janette H
Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, USA.
J Reprod Med. 2007 Jun;52(6):555-6.
Severe obstructed labor with a pelvic fistula is associated with significant fetal and maternal morbidity and mortality. It is rare in the developed world due to access to health care and availability of cesarean section for labor dystocia.
A 25-year-old primigravida in denial of her pregnancy due to a psychotic disorder experienced prolonged obstructed labor at home with fetal death, necrosis of her bladder and uterus, sepsis and profound neuropathy. Aggressive surgical and medical management, including hysterectomy and urinary diversion, resulted in survival and an enhanced potential for a good quality of life.
Severe urogenital fistula secondary to prolonged obstructed labor can occur in a metropolitan area. In the setting of psychiatric disease, physicians must be prepared for the most remote clinical situations and complications.
伴有盆腔瘘的严重梗阻性难产会导致显著的母婴发病率和死亡率。在发达国家，由于可获得医疗保健服务以及可进行剖宫产以处理产程难产，这种情况较为罕见。
一名25岁的初产妇因精神疾病否认自己怀孕，在家中经历了长时间的梗阻性难产，导致胎儿死亡、膀胱和子宫坏死、败血症以及严重的神经病变。积极的手术和药物治疗，包括子宫切除术和尿路改道，使患者得以存活并提高了获得良好生活质量的可能性。
长时间梗阻性难产继发的严重泌尿生殖瘘可发生在大都市地区。在存在精神疾病的情况下，医生必须为最罕见的临床情况和并发症做好准备。
