Etiology and factors associated with urogenital fistula among women who have undergone cesarean section: a cross-sectional study
Maroyi, Raha, Moureau, Madeline K., Brown, Heidi W., Rane, Ajay, Byabene, Gloire, and Mukwege, Denis M. (2023) Etiology and factors associated with urogenital fistula among women who have undergone cesarean section: a cross-sectional study. BMC Pregnancy and Childbirth, 23 (1). 54.
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Abstract
Background: The prevalence and impact of fistulas are more common in developing countries with limited access to emergency obstetric care. As a result, women in these settings often experience adverse psychosocial factors. The purpose of this study was to describe the characteristics of Congolese women who developed urogenital fistula following Cesarean sections (CS) to determine the characteristics associated with two etiologies: (1) prolonged obstructed labor; and (2) a complication of CS following obstructed labor.
Methods: We performed a cross-sectional study on abstracted data from all patients with urogenital fistula following CS who received care during a surgical campaign in a remote area of the Democratic Republic of the Congo (DRC). Descriptive analyses characterized patients with fistula related to obstructed labor versus CS. Univariate and multivariate logistic regression models identified factors associated with obstetric fistula after cesarean delivery following obstructed labor. Variables were included in the logistic regression models based upon biological plausibility.
Results: Among 125 patients, urogenital fistula etiology was attributed to obstructed labor in 77 (62%) and complications following CS in 48 (38%). Women with a fistula, attributed to obstructed labor, developed the fistula at a younger age (p =.04) and had a lower parity (p =.02). Attempted delivery before arriving at the hospital was associated with an increased risk of obstetric fistula after cesarean delivery following obstructed labor (p <.01).
Conclusion: CS are commonly performed on women who arrive at the hospital following prolonged obstructed labor and fetal demise, and account for almost 40% of urogenital fistula. Obstetric providers should assess maternal status upon arrival to prevent unnecessary CS and identify women at risk of developing a fistula.
| Item ID: | 78289 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1471-2393 |
| Keywords: | Cesarean section, Female, Fetal demise, Obstetric fistula, Obstructed labor, The Democratic Republic of the Congo |
| Copyright Information: | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Date Deposited: | 13 Jul 2023 02:46 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321502 Obstetrics and gynaecology @ 100% |
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