Pregnancy following obstetric fistula repair, the management of delivery

Abstract

Obstetric fistula patients invariably have dreadful obstetric histories. The antecedent delivery usually ends in a stillbirth and even multiparous obstetric fistula patients often have previous histories of multiple stillbirths and neonatal deaths. There is very little published on subsequent pregnancies following obstetric fistula repair or even on reproductive capabilities after repair. This study examines 49 pregnancies following obstetric fistula repair and the management and outcome of delivery.Keywords Caesarean section, delivery, incontinence, obstetric fistula, pregnancy.Please cite this paper as: Browning A. Pregnancy following obstetric fistula repair, the management of delivery.

Subsequent Childbirth among Obstetric Fistula Survivors with Unrepaired Fistulas in South Eastern Nigeria

“…Though 40% of the entire study population had no living child, the number of living children was higher as expected in the women with subsequent childbirth after obstetric fistula. Childless women are more likely to be divorced by their husbands as a result of their disorder, than women with living children and so it would appear that the presence of children can mediate the physical stress that threatens to overwhelm the coping abilities of the parent [6].…”

“…A study from northern Nigeria conducted among women with successful repair of fistula suggested an increase in the mean fetal birth weight and reduced incidence of low birth weight. Some related studies have demonstrated that though vaginal delivery is possible in women with successfully repaired fistula, the maternal and fetal outcomes are unfavourable and thus elective Caesarean section provides better outcomes [6,8].…”

“…Several studies have reported a high fetal wastage rate, infertility, childlessness, amenorrhoea, obstetric palsy, maternal disharmony and divorce as some of the medical and social consequences [4,5]. Though some studies have documented sexually activity [6,7] among unrepaired fistula clients there is paucity of data in the literature relating to childbirth among women with unrepaired obstetric fistula, This study thus seeks to provide information on the prevalence of childbirth among Obstetric fistula survivors with unrepaired fistula (Childbirth group-(CBG) and equally seeks to compare their profile with the profile of the remaining population of obstetric fistula survivors who were unable to achieve childbirth with unrepaired obstetric fistula (Non childbirth group-(NCBG)).…”

A Rare Case of Rectovaginal Fistula Due to Consensual Sexual Intercourse

“…6 While several researchers have indicated that the optimal mode of delivery after the successful repair of an obstetric fistula is an elective Caesarean section, the evidence for this approach is limited. 7,8 However, among women with successfullyrepaired obstetric fistulae who were allowed to deliver vaginally, 55% had their fistulae opened during delivery. 9 In the current case, the patient became pregnant twice and successfully delivered both times via elective Caesarean section.…”

Vesicovaginal fistula and pregnancy

“…Sir, From my experience in Zaria, northern Nigeria, I agree with Dr Browning 1 that the provision of a hostel adjacent to maternity units is essential as part of the antenatal care of women with previous vesicovaginal fistula (VVF) repair. In Zaria, only a small minority of the pregnant women who had VVF in a previous pregnancy used the available hostel when they needed it.…”