Nerys Benfield1, Nichole Young-Lin2, Christophe Kimona3, Luc M Kalisya3, Rogatien M Kisindja4. 1. Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: nbenfiel@montefiore.org. 2. University of California, San Francisco, San Francisco, CA, USA. 3. Department of Surgery, HEAL Africa Hospital, Goma, Democratic Republic of Congo. 4. Department of Obstetrics and Gynecology, HEAL Africa Hospital, Goma, Democratic Republic of Congo.
Abstract
OBJECTIVE: To analyze the history of women with fistula in the eastern Democratic Republic of Congo (DRC) to understand the determinants of fistula development. METHODS: In a retrospective observational study, data were analyzed from a survey of all women who underwent surgical fistula repair at HEAL Africa Hospital, Goma, between April 1, 2009, and March 1, 2012. Characteristics and obstetric histories were obtained by self-report. RESULTS: The mean age of the 202 participants at treatment was 30.7 years (range 5-69). The mean duration of fistula was 45.6 months (range 0-600). In total, 171 (91.4%) fistulas were caused by obstructed labor, and 147 (86.5%) were vesicovaginal. Most women (129/175 [73.8%]) reported having received care during early labor under the supervision of a nurse or doctor in a healthcare facility. Among 176 women for whom delivery data were available, 102 (57.9%) delivered at a hospital, 42 (23.8%) at a health center, and 32 (18.2%) at home. Only 46 (26.3%) of 175 women were transferred to a higher level of care during labor. CONCLUSIONS: In the eastern DRC, efforts to enable transport to a healthcare facility and to encourage attended births must be accompanied by improvements in the capacity of existing facilities and in the training of staff to enable the timely diagnosis of labor abnormalities and appropriate intervention.
OBJECTIVE: To analyze the history of women with fistula in the eastern Democratic Republic of Congo (DRC) to understand the determinants of fistula development. METHODS: In a retrospective observational study, data were analyzed from a survey of all women who underwent surgical fistula repair at HEAL Africa Hospital, Goma, between April 1, 2009, and March 1, 2012. Characteristics and obstetric histories were obtained by self-report. RESULTS: The mean age of the 202 participants at treatment was 30.7 years (range 5-69). The mean duration of fistula was 45.6 months (range 0-600). In total, 171 (91.4%) fistulas were caused by obstructed labor, and 147 (86.5%) were vesicovaginal. Most women (129/175 [73.8%]) reported having received care during early labor under the supervision of a nurse or doctor in a healthcare facility. Among 176 women for whom delivery data were available, 102 (57.9%) delivered at a hospital, 42 (23.8%) at a health center, and 32 (18.2%) at home. Only 46 (26.3%) of 175 women were transferred to a higher level of care during labor. CONCLUSIONS: In the eastern DRC, efforts to enable transport to a healthcare facility and to encourage attended births must be accompanied by improvements in the capacity of existing facilities and in the training of staff to enable the timely diagnosis of labor abnormalities and appropriate intervention.
Authors: Carrie J Ngongo; Thomas J I P Raassen; Marietta Mahendeka; Ladeisha Lombard; Jos van Roosmalen Journal: BMC Pregnancy Childbirth Date: 2022-07-05 Impact factor: 3.105
Authors: Stevenson K Chea; Tabitha W Mwangi; Kennedy K Ndirangu; Osman A Abdullahi; Patrick K Munywoki; Amina Abubakar; Amin S Hassan Journal: PLoS One Date: 2018-03-20 Impact factor: 3.240