ABSTRACT
Obstetric Causes The overwhelming proportions of obstetric fistulas in the developing world are complications of neglected obstructed labor. In the developed world, however, obstetric fistulas are associated with rupture of the uterus following previous cesarean section, or assisted vaginal delivery ( Table 1 ). Obstetric factors leading to ano-vaginal or recto-vaginal fistulas include an unrecognized fourth-degree tear or infection and the breakdown of repair of a third-or fourth-degree tear.
