title: Pregnancy in a patient with a vesicouterorectal fistula and obliterated vagina: a case report.
abstract: BACKGROUND
  Pregnant women with obstetric fistula are at high risk for obstetric complications and present a unique challenge in management.
  
  
  METHODS
  A young, HIV-positive woman with a history of rectovaginal and vesicovaginal fistulae after a prior delivery presented in premature labor. Upon cesarean delivery, fecal matter entered the uterus. The uterus was irrigated, closed, and a sigmoid colostomy was created. Subsequently, she underwent repair of both fistulae with bilateral ureteral reimplantation, hysterectomy, primary rectal repair, and colostomy reversal. She remains continent of urine and stool at 6 months'follow-up.
  
  
  CONCLUSIONS
  Obstetric fistula patients who conceive must be followed closely for obstetric complications and offered timely cesarean delivery.
authors.forename: Melike
authors.initials: M
authors.lastname: Harfouche
authors.forename: Stephen
authors.initials: S
authors.lastname: Kaliti
authors.forename: Mina
authors.initials: M
authors.lastname: Hosseinipour
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wilkinson
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012006:Rectovaginal Fistula; D014719:Vesicovaginal Fistula