Predictors of Obstetric Fistula Repair Outcomes in Lubango, Angola
| Autor: | Sarah Hudgins, Annelise Olson, Laurence Bernard, Robert Riviello, Mark G. Shrime, Sarah Feldman, Stacey Giles, Sam Fabiano, Andrew E Giles |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Multivariate analysis Population Logistic regression Vesicovaginal fistula Prolonged labour Young Adult 03 medical and health sciences Gynecologic Surgical Procedures 0302 clinical medicine medicine Humans Treatment Failure 030212 general & internal medicine education Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine Vesicovaginal Fistula business.industry General surgery Obstetrics and Gynecology Retrospective cohort study Odds ratio medicine.disease Angola Rectovaginal fistula Female business |
| Zdroj: | Journal of Obstetrics and Gynaecology Canada. 41:1726-1733 |
| ISSN: | 1701-2163 |
| DOI: | 10.1016/j.jogc.2019.01.025 |
| Popis: | Obstetric fistulas have a significant physical and social impact on many women in Angola. The majority of the population of this sub-Saharan African nation does not have access to high-quality obstetric care, and this is associated with a risk of prolonged labour and formation of obstetric fistulas. Fistulas are challenging to correct surgically and may require repeated operations. The objective of the study was to determine predictors of successful obstetric fistula repair.In this retrospective study, data from all recorded cases of fistula repair performed between July 2011 and December 2016 at the Centro Evangélico de Medicina do Lubango (CEML) hospital located in Lubango, Angola, were reviewed. Analysis of the data was carried out to determine factors affecting the success of fistula repair; parametric and non-parametric tests were used for group comparisons and logistic regression for outcome prediction (Canadian Task Force classification II-2).A total of 407 operations were performed on 243 women. Of these, 224 women were diagnosed with a vesicovaginal fistula and 19 with a combined vesicovaginal and rectovaginal fistula. The success rate for the attempted repairs was 42%. On multivariate analysis, the success of first surgery was negatively affected by the difficulty of repair (odds ratio 0.28; P 0.01). For patients requiring repeat surgery, the odds of success were increased with each subsequent operation (odds ratio 5.32; P 0.01).Although fistulas rated as difficult to repair had a higher likelihood of initial failure, successive attempts at repair increased the likelihood of a successful outcome. |
| Databáze: | OpenAIRE |
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