Alexandre Delamou1,2,3, Bettina Utz4, Therese Delvaux4, Abdoul Habib Beavogui5, Asm Shahabuddin4, Akoi Koivogui6, Alain Levêque7, Wei-Hong Zhang7, Vincent De Brouwere4. 1. Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium. adelamou@gmail.com. 2. Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea. adelamou@gmail.com. 3. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. adelamou@gmail.com. 4. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. 5. Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea. 6. Département Saône et Loire, Association de Dépistage Organisé des Cancers, Charnay-lès-Mâcon, France. 7. Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.
Abstract
OBJECTIVE: To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps. METHODS: A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature. RESULTS: A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death. CONCLUSION: Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed.
OBJECTIVE: To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps. METHODS: A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature. RESULTS: A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death. CONCLUSION:Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed.
Authors: Dawn M Kopp; Jeffrey Wilkinson; Angela Bengtson; Ennet Chipungu; Rachel J Pope; Margaret Moyo; Jennifer H Tang Journal: Reprod Health Date: 2017-11-28 Impact factor: 3.223
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Authors: Basile Keugoung; Kéfilath Olatoyossi Akankè Bello; Tamba Mina Millimouno; Sidikiba Sidibé; Jean Paul Dossou; Alexandre Delamou; Antoine Legrand; Pierre Massat; Nimer Ortuno Gutierrez; Bruno Meessen Journal: Learn Health Syst Date: 2020-08-28