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Re: New question-fistula and delivery routeFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Thu Nov 13 13:19:53 2003
My recommendation has always been to deliver abdominally after repair or spontaneous closure of a fistula. My wife had one with our first child and four C/S afterwards, we never regreted the C/S and wished the OB had not been so aggressive with spinal and forceps with our first - I didn't know much then, just a lowly first year medical student.
>A patient has a rectal fistula repair (etiology of the fistula not childbirth or inflammatory bowel disease related) and is now, a few years later, pregnant. She asks what the recommended route of delivery should be. I'm looking for references or articles to help her. In my training we would have recommended primary C/S but I want to know if there is different thinking now.
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