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Trop Med Int Health. 2016 Nov;21(11):1348-1365. doi: 10.1111/tmi.12771. Epub 2016 Sep 6.

Pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa: Scoping Review.

Author information

1
Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium. adelamou@gmail.com.
2
Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea. adelamou@gmail.com.
3
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. adelamou@gmail.com.
4
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
5
Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea.
6
Département Saône et Loire, Association de Dépistage Organisé des Cancers, Charnay-lès-Mâcon, France.
7
Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.

Abstract

OBJECTIVE:

To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps.

METHODS:

A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature.

RESULTS:

A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death.

CONCLUSION:

Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed.

KEYWORDS:

Afrique subsaharienne; Embarazo; Fístula obstétrica; Parto; Post-reparación; accouchement; childbirth; fistule obstétrique; grossesse; obstetric fistula; post-repair; post-réparation; pregnancy; sub-Saharan Africa; África subsahariana.

PMID:
27596732
DOI:
10.1111/tmi.12771
[Indexed for MEDLINE]
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