Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study

Abstract

Background: The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia.

Methods: A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019.  Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model.

Results: In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29 years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model.

Conclusion: Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2 weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.