Analysis of 137 obstetric fistula cases seen at three fistula centres in northwest Nigeria

Abstract

Objectives: To determine the contributory factors to development of obstetric fistula and to determine the knowledge and practice of modern contraception among fistula patients.

Design: Descriptive hospital cross-sectional study.

Setting: Three fistula centres in north west Nigeria.

Subjects: All obstetric fistula patients that met the inclusion criteria.

Results: Of 137 cases of obstetric fistula patients that satisfied the inclusion criteria, 88% had only Vesico-vaginal fistula, while 10% and 2% had recto-vaginal fistula, and combined vesico vaginal fistula and recto-vaginal fistula respectively. All the patients had early marriage (before age 20 years) with median ages at first marriage of 15 years and at presentation in hospital of 16 years. Majority (93.4%) of the patients developed fistula during the first delivery. Approximately two-third of the patients had no form of education. Only 42.3% of the patients received antenatal care and 86% delivered at home. Only 28% of the patients was aware of modern contraception and 2% had used modern contraceptive before developing fistula. All the patients expressed willingness to use modern contraception after fistula repair.

Conclusion: This study shows that child marriage, low education, unskilled birth attendance and low contraceptive uptake are common among the obstetric fistula patients in north west Nigeria. Public advocacy and formulation of laws and policies to protect girls from early marriage, girl child education to secondary school level be encouraged, public education on the importance of and utilisation of maternity and modern family planning services.