Objective To quantify surgical and quality of life outcomes 6 months after obstetric fistula repair.Design A prospective study. Women were examined and questioned at discharge and at follow-up appointment.Setting The Barhirdar Hamlin Fistula Centre, a dedicated unit treating women with obstetric fistula in northern Ethiopia.Population All women admitted to the Barhirdar Hamlin Fistula Centre suffering from vesicovaginal (WF) and rectovaginal fistulae (RVF).Methods All women were asked to return for a follow-up appointment 6 months after surgical treatment. A standardised questionnaire and examination were used and information entered into a database.Main outcomes measures Urinary and anal continence status; extent of return to previous family situation, employment, social activities and reproductive capabilities.Results Continence status at discharge was largely maintained at 6 months and quality of life was improved. Many of those incontinent on discharge improved; a small number apparently cured at discharge had later recurrence of incontinence.Conclusions Surgical treatment for obstetric fistula is successful in maintaining continence and improving quality of life of women at 6-months follow up.
The outcome of postoperative catheterization for 10 days was not inferior to that for 14 days. A similar treatment outcome with a shorter duration of catheterization will have a significant impact on reducing infection and cost.
ObjectivesTo determine the impact of volunteer obstetricians and midwife teams on obstetric services in a rural hospital in Ethiopia.MethodsThe intervention was undertaken in Mota district hospital, a rural hospital in the Amhara region of Ethiopia, which is the only hospital for 1.2 million people. Before the placement of volunteer teams it had a rudimentary basic obstetric service, no blood transfusion service, and no operative delivery. The study prospectively analyzed delivery data before, during, and after the placement of volunteer obstetrician and midwife teams. The volunteers established emergency obstetric care, and trained and supervised local staff over a 3-year period. Measurable outcomes consisted of the number of women delivering, the number of referrals of pregnant women, the number of maternal deaths, and the number of referrals of obstetric fistula patients.ResultsWith the establishment of the service the number of women attending hospital for delivery increased by 40%. In the hospital maternal mortality decreased from 7.1% to <0.5%, and morbidity, as measured by number of obstetric fistulae, decreased from 1.5% deliveries to 0.5% over the 3-year intervention period. The improvements were sustained after handing the project back to the government.ConclusionThe placement of volunteer teams was an effective method of decreasing maternal mortality and morbidity.
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