Associated Morbidities Seen in Women with Obstetric Fistula

Abstract

Background: Obstetric fistula continues to be a source of misery for women in developing countries. It usually occurs in association with other morbidities. The study was carried out to determine the morbidities that co-exist with obstetric fistula. Methodology: It was a cross-sectional descriptive study carried out among women seeking treatment of obstetric fistula in Cross River State of Nigeria. A combined purposive and proportionate sampling technique was used to select 210 participants. Ethical approval was obtained. A semi-structured interviewer-administered questionnaire was used to obtain information on biodata, obstetric characteristics and morbidties associated with obstetric fistula. Data was analyzed with SPSS version 20. Chi-square was used to compare categorical variables. A P-value of less than 0.05 was considered significant. Results: Among the 210 women, 59 (28.1%) were aged 30 and 39 years. Eighty-one women (38.6%) were grandmultipara and 80 (38.1%) had no living child. Majority (178; 84.8%) of the women delivered stillbirths. At presentation, 175 women (83.3%) had depression, 138 (65.7%) had sexual dysfunction, 97 women (46.2%) had amenorrhoea, 138 (65.7%) had secondary infertility, 128 (61%) had obstetric palsy (foot drop), 171 (81.4%) had urine dermatitis, while 49(23.3%) had features of urinary tract infection. Fifteen women 15 (7.1%) had co-existing rectovaginal fistula. Increased duration of leakage was significantly associated with development of urine dermatitis (P=0.001). Also, increased duration of labour was significantly associated with development of obstetric palsy (P=0.000). Conclusion: Morbidities associated with obstetric fistula are depression, sexual dysfunction, amenorhoea, inferlility, urine dermatitis, obstetric palsy and urinary tract infection. Fistula patients should be assessed for these and be managed by a multidisplinary team.