Vesicovaginal fistula: obstetric causes

Ramphal, Suran; Moodley, Jagidesa

doi:10.1097/01.gco.0000192980.92223.2d

Cited by 22 publications

(26 citation statements)

References 33 publications

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“…Such geographical distance not only was connected to travel time (impacting on Phase 2 delay), but connected to the idea of cost. One study attributed delay to the financial cost of treatment at short distance 29 , while seven other articles emphasised the role of financial costs [4][5]11,14,21,23,25 , which included: the cost of care at a facility, transportation costs, and the cost of upkeep for the patient and accompanying family. Five studies confirmed a more multi-faceted notion of financial constraints 4,11,20,23,26 , while two others considered the issue of opportunity costs as a great concern, alongside upkeep for the patient and accompanying family 19,28 .…”

Section: Phase 1: Delay In Deciding To Seek Carementioning

confidence: 99%

“…Four articles referenced the occurrences of deaths and fistulas due to unskilled decisions, and the neglect of patients 2,4,25,28 . Seven articles suggested that the failures of health services lie in the fact that facilities are often ill-staffed and illequipped 1,4,15,18,[24][25][26] . Thus, it is not just the number of staff that are available that impacts of the availability of adequate care, but also a question of professional competence.…”

Section: Phase 3: Delay In Receiving Adequate Carementioning

confidence: 99%

“…In considering regional issues around obstructed labour, only one article detailed that obstructed labour is common in African women due to the narrow build of their pelvis 20 . It was noted in eighteen articles that many African girls get married at an early age, which increases their risk for obstructed labour, which if not managed leads to prolonged labour [1][2][3][4]11,12,[14][15][19][20][21][22][23][24][25][26][27][28] .…”

Section: Obstructed Labourmentioning

confidence: 99%

“…In 15 of the articles, a core focus was on the seminal work by Thaddeus and Maine on the Three Phases of Delay [1][2][3][4][5]11,[15][16][19][20][21][23][24][25]28 , which is a conceptual model that identifies obstacles to the provision and timely utilisation of high quality obstetric care 29 . Consideration of the three phases occurred across these 15 articles [1][2][3][4][5]11,[15][16][19][20][21][23][24][25]28 .…”

Section: Three Phases Of Delaymentioning

confidence: 99%

“…The core focuses of the articles remained on two central factors driving Phase 1 delay: geography and cost. Eight of the articles mention that, more often than not, in rural areas health care facilities are sparse, resulting in people having to travel great distances to access health care [3][4][5]11,15,[24][25][26][27][28] . Such geographical distance not only was connected to travel time (impacting on Phase 2 delay), but connected to the idea of cost.…”

Section: Phase 1: Delay In Deciding To Seek Carementioning

confidence: 99%

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Obstetric Fistula: A Narrative Review of the Literature on Preventive Interventions in sub-Saharan Africa

Lufumpa

Steele

2016

Afr J Reprod Health

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Obstetric fistulas are childbearing injuries that present a major public health issue, especially in the developing context. This study brings together the literature on the causes of these injuries in sub-Saharan Africa, as well as suggested interventions aimed at its prevention. Furthermore, it also aims to identify gaps in the research that need to be addressed. A systematic search of PubMed, Embase, Web of Science, and Scopus identified that extensive research has been carried out on the factors causing this injury, the main factors being complications during labour, three phases of delay, and culture. Nonetheless, there remains a dearth of literature detailing preventive measures. While few studies discussed preventive interventions that had been implemented, the literature does well to suggested preventive interventions. Suggested preventive measures target the community, as well as healthcare facilities. The literature also highlights the need for increased governmental support, as a means of preventing the development of fistulas. Using narrative review methods, we identify that the research focus remains primarily on the causes of obstetric fistula and ways of managing the injury, while paying less attention to means of preventing this injury. We therefore recommend further exploration of preventive measures. RésuméLes fistules obstétricales sont des blessures d'accouchement qui présentent un problème considérable de santé publique, en particulier dans le contexte des pays en voie de développement. Cette étude rassemble la documentation sur les causes de ces blessures en Afrique subsaharienne, ainsi que les interventions proposées visant à sa prévention. En outre, il vise également à identifier les lacunes dans la recherche qui doivent être abordées. Une recherche systématique sur les bases de données PubMed, Embase, Web of Science, et Scopus a révélé que des recherches approfondies ont été menées sur les causes de cette blessure, les principaux facteurs étant les complications pendant l'accouchement, les trois étapes de retard, et la culture. Néanmoins, il reste encore un manque de documentation détaillant les mesures préventives. Malgré que peu d'études aient discuté des interventions préventives qui avaient été mises en oeuvre, la documentation a bienfait de proposer des interventions préventives. Ces mesures proposées ciblent la communauté, ainsi que les centres médicaux. La documentation met également en évidence la nécessité d'un soutien accru de la part du gouvernement, comme un moyen d'empêcher le développement des fistules. En utilisant des méthodes de recherche pour les examens narratifs, nous identifions que la documentation se concentre principalement sur les causes de la fistule obstétricale et les moyens de traiter cette blessure, tout en accordant moins d'attention à la prévention de cette blessure. Par conséquent, nous recommandons une exploration plus approfondi sur les mesures de prévention. (Afr J Reprod Health 2016 (Edition Spéciale); 20[3]: 118-126).

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Section: Phase 1: Delay In Deciding To Seek Carementioning

confidence: 99%

Section: Phase 3: Delay In Receiving Adequate Carementioning

confidence: 99%

Section: Obstructed Labourmentioning

confidence: 99%

Section: Three Phases Of Delaymentioning

confidence: 99%

Section: Phase 1: Delay In Deciding To Seek Carementioning

confidence: 99%

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Obstetric Fistula: A Narrative Review of the Literature on Preventive Interventions in sub-Saharan Africa

Lufumpa

Steele

2016

Afr J Reprod Health

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Rising trends in iatrogenic urogenital fistula: A new challenge

Tasnim

Bangash

Amin

et al. 2020

Intl J Gynecology & Obste

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Objective: To analyze trends in iatrogenic urogenital fistula among patients admitted for fistula repair at the Pakistan Institute of Medical Sciences, Islamabad.Methods: In this longitudinal study, all patients who presented for fistula repair between 2006 and 2018 were included in the study. Patient data were collected on age, parity, and type and etiology of fistula, which was classified as ischemic or iatrogenic. Results:Of 634 fistula patients, 371 (58.5%) had iatrogenic fistula, while 263 (41.5%) patients developed ischemic fistula due to obstructed labor. Mean age of patients was 31.6 years. Yearly trends showed an increase in iatrogenic fistula from 43.2% in 2006-2008 to 71.4% in 2017-2018. The major etiological contributor to iatrogenic fistula was hysterectomy (52.5%), followed by cesarean hysterectomy (26.4%), and cesarean delivery (19.9%). Conclusion:A rising trend in iatrogenic fistula was observed. This emphasizes the need for optimization of surgical approaches and surgical skills. Moreover, gynecologic surgeries should be restricted to authorized gynecologic surgeons. K E Y W O R D S Iatrogenic fistula; Obstetric fistula; Pakistan; Trends quality of health care and training systems. Although surgical training offers a possible solution, health personnel may not have gained adequate practical experience to deal with complicated deliveriesand surgical procedures. Therefore, there is a need for advanced training for improved decision-making and surgical skills in both obstetric and gynecologic management, especially for safe cesarean delivery and hysterectomy. Furthermore, despite the declining trend in obstetric fistula, measures must also be taken to further improve health services in access-restricted areas. These measures will ultimately lead to a better healthcare system and decrease the rate of fistula development.In conclusion, the present study observed a rising trend in iatrogenic fistula over almost 12 years at a single center in Islamabad, Pakistan. These recent increasing trends in iatrogenic urogenital fistula emphasize the importance of improving safety standards for surgical techniques, both obstetric and gynecologic. AUTHOR CONTRIBUTIONSNT designed and directed the project and drafted the manuscript. KB directed the project and carried out data collection. OA performed data analysis and interpretation and drafted and critically revised the manuscript. SL and HH conducted data collection.

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Co-occurrence of Obstetric Fistula and Stillbirth in Sub-Saharan Africa

Cowgill

2022

Global Maternal and Child Health

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Vesicovaginal fistula: obstetric causes

Cited by 22 publications

References 33 publications

Obstetric Fistula: A Narrative Review of the Literature on Preventive Interventions in sub-Saharan Africa

Obstetric Fistula: A Narrative Review of the Literature on Preventive Interventions in sub-Saharan Africa

Rising trends in iatrogenic urogenital fistula: A new challenge

Co-occurrence of Obstetric Fistula and Stillbirth in Sub-Saharan Africa

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