Comparison of patterns of obstetric fistula between two periods in South-East Nigeria

Abstract

Obstetric fistula continues to be a reproductive health problem among women in low- and middle-income countries. The study aimed to compare the demographics, aetiology, presentation, management of fistula patients seen at two different periods. It was a retrospective comparative cross-sectional study of fistula patients managed in 2015 and 2020 at the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria. A total sampling of all the patients who had obstetric fistula repair within the study periods was done. Medical records of the women were obtained. Data was analysed using the SPSS version 21. Numerical variables were compared with the student’s t-test while categorical variables were compared using the Chi-square test. A p-value of less than 0.05 was considered significant. A total of 229 women had repair of obstetric fistula, 143 in 2015 and 86 in 2020. The mean ages of the women treated in 2015 and 2020 were 35.3±10.8 years and 35.0±11.8 years respectively (P=0.333). In 2015, the commonest cause of fistula was prolonged obstructed labour while in 2020, it was Caesarean section (60.3% vs 43.0%, P<0.001). Stillbirth was the commoner (65.4%) fetal outcome in 2015 as against live birth in 2020 (65.4% vs 54.4%, P=0.004). Abdominal approach to repair increased from 4.2% of procedures in 2015 to 11.6% in 2020 (P=0.033). There was no change in the socio-demographic characteristics of the women treated within the two periods. Caesarean section is now the commonest aetiology of obstetric fistula. Most babies now survive the antecedent pregnancy with abdominal repairs now on the increase.