The Fetal Outcome and Fetal Wastage Pattern among Different Types of Obstetric Fistula at the National Obstetric Fistula Centre, Abakaliki, Nigeria

摘要

BACKGROUND : Obstetric Fistula is a major public health problem in developing world. It is associated with a high fetal wastage rate. The objective of this study was to evaluate different types of obstetric fistula and their fetal wastage rate. METHOD : A retrospective population study was done at the National Obstetric Fistula Centre, Abakaliki between 1~(st) January-31~(st) December, 2016. The calculated minimum sample size was 3, however, the total number of 203 patients were studied. The case notes of all the women who had obstetric fistula repairs over the period were analyzed. RESULTS : The mean age from this study was 38 ± 12.1 years. The fetal wastage rate from this study was 82.76% while the live birth was 17.24%. Seventy percent of the stillbirth were delivered via SVD, while 11% of stillbirth were delivered through EmCS. Twelve different types of fistula were identified in this study using anatomical classifications. Large extensive fistula, urethral loss and multiple fistula had the highest fetal wastage of 100% respectively. This was followed by mid-vaginal fistula (95.7%), Juxtaurethral fistula 94.4%, Juxtacervical fistula 88.5%, Intracervical fistula 85.71%, Ureteric fistula 85.71%, Vesicouterine 84.21%, Vault fistula 62.5%. Rectovaginal fistula had the least fetal wastage of 15.79% and the highest live birth of 84.2%. CONCLUSION : The findings showed a high fetal wastage rate amongst women with obstetric fistula. There was high fetal wastage across different types of obstetric fistula. Rectovaginal fistula had the best outcome in terms of live births.