Epidemiological and Clinical Aspects of Obstetric Fistulas Managed in Six Health Structures in the Central African Republic  

作　　者：Roch M’Betid-Degana Gilles-Davy Kossa-Ko-Ouakoua Saturnin Heya-Imbatia Georges Crépin Beyam-Yobima Martial Mbida Sabrina Ouapou Géniva Gracelia Vanciane M’Betid-Degana Serge Ndakala Christine Amisi Eugène Serdouma Norbert Richard Ngbale Abdoulaye Sepou Roch M’Betid-Degana;Gilles-Davy Kossa-Ko-Ouakoua;Saturnin Heya-Imbatia;Georges Crépin Beyam-Yobima;Martial Mbida;Sabrina Ouapou;Géniva Gracelia Vanciane M’Betid-Degana;Serge Ndakala;Christine Amisi;Eugène Serdouma;Norbert Richard Ngbale;Abdoulaye Sepou(Department of Gynecology and Obstetric, University Hospital Center of the Sino-Central African Friendship, Bangui, Central African Republic;Department of Gynecology and Obstetric, Camp Henri IZAMO Hospital (National Gendarmerie), Bangui, Central African Republic;Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic;Department of Surgery, University Hospital Center of the Sino-Central African Friendship, Bangui, Central African Republic;Panzi Foundation, Bukavu, Democratic Republic of Congo;Department of Gynaecology and Obstetric, University Hospital Center Community, Bangui, Central African Republic)

机构地区：[1]Department of Gynecology and Obstetric, University Hospital Center of the Sino-Central African Friendship, Bangui, Central African Republic [2]Department of Gynecology and Obstetric, Camp Henri IZAMO Hospital (National Gendarmerie), Bangui, Central African Republic [3]Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic [4]Department of Surgery, University Hospital Center of the Sino-Central African Friendship, Bangui, Central African Republic [5]Panzi Foundation, Bukavu, Democratic Republic of Congo [6]Department of Gynaecology and Obstetric, University Hospital Center Community, Bangui, Central African Republic

出　　处：《Open Journal of Obstetrics and Gynecology》2025年第1期138-146,共9页妇产科期刊(英文)

摘　　要：Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.

关 键 词：Obstetric Fistulas EPIDEMIOLOGY TREATMENT Central African Republic 

分 类 号：R73[医药卫生—肿瘤]