The obstetric fistula: factors associated with improved pregnancy outcome after a successful repair.

A retrospective study of 155 pregnant patients with obstetric fistulae was conducted to determine the factors associated with improvement in the pregnancy outcome. The successful repair of the fistula was associated with a reduced abortion rate (4.0%), incidence of premature rupture of the membranes (1.3%) perinatal mortality (13.0%) as well as an increase in the mean fetal birthweight and reduced incidence of low birth (20.3%). Antenatal supervision of pregnancy increased the acceptance rate for elective cesarean section and was associated with early referral of cases to hospital during labor. The patients having their first pregnancies since the onset of their fistulae delayed longest in labor at home (15.6 h) hence had the highest perinatal mortality and rate of recurrence of obstetric fistula. Therefore the successful repair of the obstetric fistula together with an aggressive drive to improve antenatal supervision especially directed at the younger patients will improve acceptance of the policy of elective cesarean delivery and therefore the overall pregnancy outcome among these patients.