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Notice bibliographique (sans auteurs) :

Cesarean delivery-related fistulae in the Democratic Republic of Congo - International Journal of Gynecology & Obstetrics - Vol. 114, 1 - ISBN: 0020-7292 - p.10-14

Auteur·e(s) :

Onsrud, Mathias; Sjøveian, Solbjørg; Mukwege, Denis

Année de publication :

2011

URL(s) :

http://www.sciencedirect.com/science/article/pii/S…
https://doi.org/10.1016/j.ijgo.2011.01.018

Résumé (français)  :

Abstract (English)  :

Objective
To compare the characteristics of urogenital fistulae after cesarean delivery with those after spontaneous vaginal delivery.
Methods
A retrospective analysis of hospital records of 597 consecutive patients with a urogenital fistula who received treatment at Panzi Hospital, Bukavu, Democratic Republic of Congo, during 2005–2007.
Results
Of 576 women with an obstetric fistula, 229 (40%) had had a cesarean delivery; 55 (24%) of the 229 fistulae were considered to be iatrogenic. The distribution of risk factors (age, stature, parity, and labor duration) was similar to that among 226 women with a spontaneous vaginal delivery, but the odds ratios for having a ureterovaginal or a vesicouterine fistula were 11.9 (95% confidence interval [CI] 2.8–51.2) and 9.5 (95% CI 2.8–31.9), respectively. Vesicovaginal fistulae with cervical involvement were also significantly more frequent in the cesarean delivery group. The fistulae in this group had less surrounding fibrosis and there was less treatment delay. Stillbirth rates were 87% (cesarean delivery) and 95% (spontaneous vaginal delivery).
Conclusion
The data indicate that cesarean delivery-related fistulae are a separate clinical entity. Focus on this condition is important for fistula prevention and provision of adequate obstetric care, particularly for training in surgery and alternative delivery methods.

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Mots-clés :

➡ prévention ; fistule

Auteur·e de cette fiche :

Import 03/08/2014 — 03 Aug 2014
➡ dernière modification : Marion Corbe — 03 Aug 2014