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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cesarean delivery-related fistulae in the Democratic Republic of Congo
International Journal of Gynecology and Obstetrics, Volume 114, No. 1, Year 2011
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Description
Objective: To compare the characteristics of urogenital fistulae after cesarean delivery with those after spontaneous vaginal delivery. Methods: A retrospective analysis of hospital records of 597 consecutive patients with a urogenital fistula who received treatment at Panzi Hospital, Bukavu, Democratic Republic of Congo, during 2005-2007. Results: Of 576 women with an obstetric fistula, 229 (40%) had had a cesarean delivery; 55 (24%) of the 229 fistulae were considered to be iatrogenic. The distribution of risk factors (age, stature, parity, and labor duration) was similar to that among 226 women with a spontaneous vaginal delivery, but the odds ratios for having a ureterovaginal or a vesicouterine fistula were 11.9 (95% confidence interval [CI] 2.8-51.2) and 9.5 (95% CI 2.8-31.9), respectively. Vesicovaginal fistulae with cervical involvement were also significantly more frequent in the cesarean delivery group. The fistulae in this group had less surrounding fibrosis and there was less treatment delay. Stillbirth rates were 87% (cesarean delivery) and 95% (spontaneous vaginal delivery). Conclusion: The data indicate that cesarean delivery-related fistulae are a separate clinical entity. Focus on this condition is important for fistula prevention and provision of adequate obstetric care, particularly for training in surgery and alternative delivery methods. © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Authors & Co-Authors
Onsrud, Mathias
Norway, Oslo
Ulleval University Hospital
Sjøveian, Solbjørg
Norway, Oslo
Universitetet I Oslo
Mukwege, Dénis Mukengere
Congo
Panzi Hospital
Statistics
Citations: 53
Authors: 3
Affiliations: 3
Identifiers
Doi:
10.1016/j.ijgo.2011.01.018
ISSN:
00207292
e-ISSN:
18793479
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Congo
Participants Gender
Female