Pelvic Ultrasound Findings in Women with Obstetric Fistula: A Cross-Sectional Study of Cases and Controls

Author:

Wilkinson Jeffrey P.1ORCID,Bengtson Angela M.2,Chipungu Ennet3,Pope Rachel J.1ORCID,Makanani Bonus4,Moyo Margaret3,Mwale Mwawi5,Tang Jennifer H.6ORCID

Affiliation:

1. Baylor College of Medicine, Department of Obstetrics and Gynecology, Global Women’s Health, Baylor Plaza, Houston, TX 77030, USA

2. University of North Carolina, Department of Epidemiology, 401 Rosenau Hall, Chapel Hill, NC 27599-7455, USA

3. Freedom from Fistula Foundation, Fistula Care Centre, Lilongwe, Malawi

4. Department of Obstetrics and Gynecology, Malawi College of Medicine, Blantyre, Malawi

5. Malawi Ministry of Health, Bwaila Maternity Hospital, Lilongwe, Malawi

6. University of North Carolina, Department of Obstetrics and Gynecology, 101 Manning Drive, Chapel Hill, NC 27599-7570, USA

Abstract

Objective. Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods. This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18–45, prior pregnancy, and a uterus on ultrasound. Participants underwent endovaginal ultrasound with measurement of cervical dimensions. Comparisons were done using t-tests and Fisher's exact test. Among women with OF, linear regression was used to assess whether fistula stage was associated with cervical length. Results. We enrolled 98 cases and 12 controls. Women with OF had shorter cervical lengths (18.8 mm versus 27.3 mm, p < 0.01), as well as shorter anterior (7.0 mm versus 9.3 mm, p < 0.01) and posterior (9.5 mm versus 11.0 mm, p < 0.04) cervical stroma, compared to controls. Conclusion. Women with OF have shorter cervical lengths and anterior and posterior cervical stroma, when compared to women without OF. This may offer a partial explanation for subfertility and poor obstetric outcomes in OF patients. Additional studies to clarify the role of ultrasound in OF patients and prediction of future fertility are warranted.

Publisher

Hindawi Limited

Subject

Obstetrics and Gynecology

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Surgical Treatment for Obstetric Fistula: Not an Easy Option;Global Maternal and Child Health;2022

2. Clinical Characteristics of Urogenital Fistulas in PMCH Nawabshah: A Cross-sectional Study;Journal of Pharmaceutical Research International;2021-06-11

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