ArticleBJOG : an international journal of obstetrics and gynaecology2020
Delivery mode for prolonged, obstructed labour resulting in obstetric fistula: a retrospective review of 4396 women in East and Central Africa.
Article in BJOG : an international journal of obstetrics and gynaecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 31 citations in OpenAlex.
- Spatial disparities and determinants of obstetric fistula among childbearing women in sub-Saharan Africa: A geospatial regression approach.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Incidence, management and outcomes of prolonged second stage of labour in a rural setting in Malawi: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Epidemiology, etiology and treatment of female vaginal injury.Reproductive health · 2025Review
- A Gender Perspective on Coloproctological Diseases: A Narrative Review on Female Disorders.Journal of clinical medicine · 2024Review
- Equivalence between physicians and associate clinicians in the frequency of iatrogenic urogenital fistula following cesarean section in Tanzania and Malawi.Human resources for health · 2024Article
- Reconsidering the developmental origins of adult disease paradigm: The 'metabolic coordination of childbirth' hypothesis.Evolution, medicine, and public health · 2024Review
- Women's knowledge of symptoms of obstetric fistula, experiences, and associated factors in Sierra Leone.PloS one · 2024Article
- Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea.BMC pregnancy and childbirth · 2023Article
- Etiology and factors associated with urogenital fistula among women who have undergone cesarean section: a cross-sectional study.BMC pregnancy and childbirth · 2023Article
- A retrospective review of genital fistula occurrence in nine African countries.BMC pregnancy and childbirth · 2022Article
- Iatrogenic genito-urinary fistula following cesarean birth in nine sub-Saharan African countries: a retrospective review.BMC pregnancy and childbirth · 2022Article
- Article
- Preventing stillbirth from obstructed labor: A sensorized, low-cost device to train in safer operative birth.Frontiers in global women's health · 2022Article
- Emerging Predictors of Obstructed Labour in a Single Nigerian Centre Population of a Low Resource Setting.Trends in medical research · 2022Article
- Cesarean delivery in low- and middle-income countries: A review of quality of care metrics and targets for improvement.Seminars in fetal & neonatal medicine · 2021Review
- Delivery mode for prolonged, obstructed labour resulting in obstetric fistula: a retrospective review of 4396 women in East and Central Africa.BJOG : an international journal of obstetrics and gynaecology · 2020Article
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the mode of delivery and stillbirth rates over time among women with obstetric fistula.
designRetrospective record review.
settingTanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia and Ethiopia. POPULATION: A total of 4396 women presenting with obstetric fistulas for repair who delivered previously in facilities between 1990 and 2014.
methodsRetrospective review of trends and associations between mode of delivery and stillbirth, focusing on caesarean section (CS), assisted vaginal deliveries and spontaneous vaginal deliveries.
main outcome measuresMode of delivery, stillbirth.
resultsOut of 4396 women with fistula, 3695 (84.1%) delivered a stillborn baby. Among mothers with fistula giving birth to a stillborn baby, the CS rate (overall 54.8%, 2027/3695) rose from 45% (162/361) in 1990-94 to 64% (331/514) in 2010-14. This increase occurred at the expense of assisted vaginal delivery (overall 18.3%, 676/3695), which declined from 32% (115/361) to 6% (31/514).
conclusionsIn Eastern and Central Africa, CS is increasingly performed on women with obstructed labour whose babies have already died in utero. Contrary to international recommendations, alternatives such as vacuum extraction, forceps and destructive delivery are decreasingly used. Unless uterine rupture is suspected, CS should be avoided in obstructed labour with intrauterine fetal death to avoid complications related to CS scars in subsequent pregnancies. Increasingly, women with obstetric fistula add a history of unnecessary CS to their already grim experiences of prolonged, obstructed labour and stillbirth. TWEETABLE ABSTRACT: Caesarean section is increasingly performed in African women with stillbirth treated for obstetric fistula.
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