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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predicting women at risk for developing obstetric fistula: A fistula index? An observational study comparison of two cohorts
BJOG: An International Journal of Obstetrics and Gynaecology, Volume 121, No. 5, Year 2014
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Description
Objective To ascertain if a predictor of obstructed labour and obstetric fistula (OF) occurrence could be devised. Design Observational study of two cohorts. Setting Selian Lutheran Mission Hospital, Arusha, Tanzania and Aberdeen Women's Centre, Freetown, Sierra Leone. Population All women presenting with OF caused by obstructed labour and all women having a normal vaginal delivery (NVD) at both institutions were eligible for the study. Methods All women with OF and those delivering normally had their height in centimetres measured and their intertuberous space measured by the number of examiner's knuckles admitted. The dimensions for OF and normal delivery were examined individually and multiplied to gain a 'fistula index'. Main outcomes measures Dimensions and index were compared statistically between OF and NVD women using t tests. Sensitivity, specificity and predictive values from receiver operating characteristic curves were obtained for predicting OF. Results There were statistical differences between the groups with OF women being significantly shorter, having a smaller intertuberous space and lower fistula index than those undergoing NVD (each P < 0.001). Sensitivity was high for fistula index ≤ 507.5 (94.9%, 95% confidence interval 83.1-98.6%) and for intertuberous space of at least three knuckles (92.3%, 95% CI 79.7-97.3%) alone. Conclusions A simple antenatal measurement of intertuberous space could screen those women at higher risk of needing medical intervention to prevent OF. © 2014 Royal College of Obstetricians and Gynaecologists.
Authors & Co-Authors
Browning, Andrew S.
Tanzania
Selian Fistula Project
Lewis, Alyona F.
Sierra Leone, Freetown
Aberdeen Women's Centre
Whiteside, Sigrid
United Kingdom, Manchester
The University of Manchester
Statistics
Citations: 17
Authors: 3
Affiliations: 3
Identifiers
Doi:
10.1111/1471-0528.12527
ISSN:
14700328
e-ISSN:
14710528
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
Sierra Leone
Tanzania
Participants Gender
Female