Obstetrics and Gynecology International最新文献

{"title":"Rate of Nondiagnostic Computerized Tomography Pulmonary Angiograms (CTPAs) Performed for the Diagnosis of Pulmonary Embolism in Pregnant and Immediately Postpartum Patients.","authors":"Sarah Hogan,&nbsp;Jillian Greene,&nbsp;Jeffery Flemming","doi":"10.1155/2019/1432759","DOIUrl":"https://doi.org/10.1155/2019/1432759","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the nondiagnostic rate of computed tomography pulmonary angiography (CTPA) in pregnant and postpartum patients with suspected pulmonary embolism (PE) to determine whether CTPA or ventilation-perfusion (VQ) scan should be considered first line imaging in this patient population considering their equivalent accuracy and the greater radiation exposure to proliferating breast tissue of CTPA.</p><p><strong>Methods: </strong>All pregnant/postpartum female patients between 18 and 50 years of age who had CTPA within the Eastern Health Authority between November 2012 and November 2016 were included. Each scan was evaluated for nondiagnosis based on two criteria: contrast density in the main pulmonary artery, and respiratory motion artefact. If either of these criteria were not met, the scan was labelled as nondiagnostic.</p><p><strong>Results: </strong>The nondiagnostic rate overall was 43% (<i>n</i>=83). This is similar to current literature values for rates of CTPA nondiagnosis, and comparable to the reported diagnostic quality of the reporting radiologist. This is much greater compared to rates of ventilation/perfusion nondiagnosis in comparable populations. Even in patients with normal chest radiographs, which represents the main patient group where VQ may be considered as an alternative, the nondiagnostic rate of CT is much higher.</p><p><strong>Conclusion: </strong>This is the first study to attempt to identify an objective method of determining nondiagnosis in pregnant and postpartum patients undergoing a CTPA. Our results strengthen the argument that alternative imaging should be considered when investigating for PE in this population in order to protect the proliferating breast tissue, and VQ scan should be considered especially in patients with normal chest X-rays.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2019 ","pages":"1432759"},"PeriodicalIF":1.9,"publicationDate":"2019-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1432759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37206800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Clear Cell Adenocarcinoma of the Cervix: A Clinical Analysis of 18 Cases without Exposure to Diethylstilbestrol.","authors":"Dongying Wang, Chunhua Zhao, Li Fu, Yang Liu, Weiyang Zhang, Tianmin Xu","doi":"10.1155/2019/9465375","DOIUrl":"10.1155/2019/9465375","url":null,"abstract":"<p><strong>Objectives: </strong>Cervical clear cell adenocarcinoma (CCAC) is a rare malignant tumor with independent biological behavior in the female reproductive system. In this report, we collect the clinical and histopathological characteristics of 18 CCAC patients without exposure to diethylstilbestrol (DES) and conduct relevant clinical analysis.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 18 patients with CCAC who were diagnosed and treated from January 2009 to August 2017 in the Second Hospital of Jilin University.</p><p><strong>Results: </strong>A total of 18 patients were enrolled. The age of patients ranged from 37 to 74 years with the peak incidence between 45 and 55 years. The median age was 53 years. The most common symptom was vaginal bleeding (66.7%, 12/18). The most common type of lesion was the endocervical type (66.7%, 12/18). The negative rate of human papillomavirus (HPV) examination was 88.9% (8/9). Based on the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO) cervical cancer clinical stage in 2018, 55.6% patients were stage I (<i>n</i>=10), 16.7% were stage II (<i>n</i>=3), 22.2% were stage III (<i>n</i>=4), and 5.6% were stage IV (<i>n</i>=1). Seventeen patients underwent surgery; 64.7% (11/17) of cases showed infiltration of the entire layer of the cervix, pelvic lymph node (PLN) metastasis was observed in 4 patients (26.7%, 4/15), endometrium metastasis was observed in 4 patients (25%, 4/16), and 13 patients (72.2%, 13/18) were diagnosed at an early stage (stage IB1-IIA2). Fifteen patients' immunohistochemistry indicated that napsin A, CK7, CK (AE1/AE3), and PAX-8 were positive, and p53, p16, ER, and vimentin were expressed to different degrees. Follow-up data were obtained in 13 patients (72.2%, 13/18). One patient died of recurrence 5 months after surgery, and the other patients' progression-free survival (PFS) ranged from 9 to 59 months. Tumor size (>4 cm), tumor stage (FIGO IIA2-IV), PLN, and endometrium metastasis had negative effects on PFS (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>CCAC is a highly invasive malignant tumor, whose pathogenesis may not be associated with HPV infection. Radical hysterectomy combined with chemotherapy (paclitaxel + platinum) has the ideal short-term curative effect. In the future, larger samples of clinical data are required to confirm these insights.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2019 ","pages":"9465375"},"PeriodicalIF":1.6,"publicationDate":"2019-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37206801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our Experience with Iatrogenic Ureteric Injuries among Women Presenting to University College Hospital, Ibadan: A Call to Action on Trigger Factors.","authors":"Olatunji Lawal,&nbsp;Oluwasomidoyin Bello,&nbsp;Imran Morhason-Bello,&nbsp;Rukiyat Abdus-Salam,&nbsp;Oladosu Ojengbede","doi":"10.1155/2019/6456141","DOIUrl":"https://doi.org/10.1155/2019/6456141","url":null,"abstract":"<p><strong>Background: </strong>Ureteric injuries leading to ureterovaginal fistula (UVF) is less common than vesicovaginal fistula, as a cause of urinary incontinence. Recently, there is a surge in the number of UVF cases presenting to University College Hospital (UCH) following a caesarean delivery. The urogynaecology unit at UCH is at the forefront of providing surgical repair for women with all forms of genitourinary fistulas. We describe our experience with managing UVF arising from ureteric injury.</p><p><strong>Methods: </strong>A retrospective data collection of UVF cases managed from January 2012-December 2017 at UCH is presented. Information on sociodemographic and obstetric characteristics, presenting complaints, antecedent surgery, treatment received, findings at surgery, and postoperative complications were obtained with a structured proforma.</p><p><strong>Results: </strong>Eighteen cases of UVFs due to iatrogenic ureteric injury were managed. Majority (<i>N</i>=11; 61.1%) of the women suffered the injury following the emergency caesarean section (EMCS). Abdominal hysterectomy operation accounted for four (22.2%) cases, and one case each (5.6%) was due to vaginal hysterectomy and destructive operations. Prolonged obstructed labour (POL) (81.8%) was the most common indication for the EMCS, while 18.2% had surgery on account of lower uterine segment fibroid. Most of the ureteric injuries were on the left side. Postoperative complications documented were haemorrhage, urinary tract infection, wound infection, and injury to the neighbouring structure.</p><p><strong>Conclusion: </strong>Caesarean section being one of the most performed surgical operations in Nigeria was surprisingly found to be the most common cause of ureteric injury ahead of hysterectomy. It is a pointer that the surgeons might not have properly learnt the art of the caesarean delivery well. We recommend adequate surgical training of medical officers/surgeons that are involved.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2019 ","pages":"6456141"},"PeriodicalIF":1.9,"publicationDate":"2019-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6456141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37065271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Maternal Death in a Pastoralist Area of Borena Zone, Oromia Region, Ethiopia: Unmatched Case-Control Study.","authors":"Jarso Sara,&nbsp;Yusuf Haji,&nbsp;Achamyelesh Gebretsadik","doi":"10.1155/2019/5698436","DOIUrl":"https://doi.org/10.1155/2019/5698436","url":null,"abstract":"<p><strong>Background: </strong>Globally, more than 830 maternal deaths happen daily, and nearly, all of these occur in developing countries. Similarly, in Ethiopia, maternal mortality is still very high. Studies done in pastoralist women are almost few. Therefore, the objective of this study was to assess the determinant factors of maternal death in the pastoralist area of Borena zone, Oromia region, Ethiopia.</p><p><strong>Methods: </strong>Community-based unmatched case-control study was conducted on 236 mothers (59 maternal deaths (cases) and 177 controls). The sample included pregnant women aged 15-49 years from September 2014 to March 2017. Data were collected using a structured questionnaire adapted from Maternal Death Surveillance and Response Technical Guideline, entered into the EpiData, exported into SPSS for analyses. Odds ratios (ORs) and 95% confidence interval (CI) were computed to determine contributing factors of maternal death and control potential confounding variables.</p><p><strong>Results: </strong>About 51 (86%) of all maternal deaths were due to direct obstetric causes. Of this, hemorrhage (45%), hypertensive disorders of pregnancy (23%), and obstructed labor (18%) were the leading direct causes of maternal deaths. Husbands who had no formal education were 5 times higher compared with their counterparts (AOR = 5.1, 95% CI: 1.6-16). Mothers who were not attending ANC were 5 times more at risk for death than those who attend (AOR 5.3, 95% CI 2.3-12.1). Mothers who gave birth at home/on transit were twice to die compared to health facility delivery (AOR 2.6, 95% CI 2.4-6) that were contributing factors of maternal deaths.</p><p><strong>Conclusions: </strong>Husband's level of education, lack of antenatal care, and home delivery were the factors contributing to maternal deaths in the zone. Frequent and tailored antenatal care, skilled delivery, and access to education also need due attention.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2019 ","pages":"5698436"},"PeriodicalIF":1.9,"publicationDate":"2019-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5698436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36999046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gynecologists May Underestimate the Amount of Blood Loss during Total Laparoscopic Hysterectomy.","authors":"Masakazu Sato,&nbsp;Minako Koizumi,&nbsp;Kei Inaba,&nbsp;Yu Takahashi,&nbsp;Natsuki Nagashima,&nbsp;Hiroshi Ki,&nbsp;Nao Itaoka,&nbsp;Chiharu Ueshima,&nbsp;Maki Nakata,&nbsp;Yoko Hasumi","doi":"10.1155/2018/3802532","DOIUrl":"https://doi.org/10.1155/2018/3802532","url":null,"abstract":"<p><strong>Background: </strong>We considered the possibility of underestimation of the amount of bleeding during laparoscopic surgery, and we investigated comparing the amount of bleeding between laparoscopic surgery and open surgery by considering the concentration of hemoglobin before and after surgery as indicators.</p><p><strong>Methods: </strong>The following procedures were included: A, surgery for ovarian tumor; B, myomectomy; and C, hysterectomy either by laparoscopic surgery or open surgery. Patients who underwent the above procedures in between January 1, 2010, and December 31, 2017, were enrolled. We identified 1749 cases (A: 90, B: 105, and C: 325 of open surgery and A: 667, B: 437, and C: 125 of laparoscopic surgery). We considered the sum as an estimation of blood loss during surgery and the change in the value of hemoglobin in laboratory testing one day before and after surgery.</p><p><strong>Results: </strong>During laparoscopic surgery, the measurements of blood loss included the following: A: 59.8 ml; B: 168.6 ml; and C: 206.8 ml. During open surgery, measurements of blood loss included the following: A: 130.7 ml; B: 236.7 ml; and C; 280.9 ml. The reduction of hemoglobin after surgery compared with that before surgery was less in laparoscopic surgery than that in open surgery in A and B; however, this reduction was not significantly different in C.</p><p><strong>Conclusion: </strong>Our results suggest that the estimation of the bleeding in A and B was appropriate; however, the estimation might be underestimated in C during laparoscopic surgery.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"3802532"},"PeriodicalIF":1.9,"publicationDate":"2018-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3802532","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36910451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach.","authors":"Samara Levine,&nbsp;Ozgul Muneyyirci-Delale","doi":"10.1155/2018/9253083","DOIUrl":"https://doi.org/10.1155/2018/9253083","url":null,"abstract":"<p><p>While prolactin is most well known for its role in lactation and suppression of reproduction, its physiological functions are quite diverse. There are many etiologies of hyperprolactinemia, including physiologic as well as pathologic causes. Physiologic causes include pregnancy, lactation, sleep-associated, nipple stimulation and sexual orgasm, chest wall stimulation, or trauma. Stress is also an important physiologic cause of hyperprolactinemia, and its clinical significance is still being explored. This review will provide an overview of prolactin physiology, the role of stress in prolactin secretion, as well as the general clinical approach to hyperprolactinemia.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"9253083"},"PeriodicalIF":1.9,"publicationDate":"2018-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/9253083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36849806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pubococcygeal Sling versus Refixation of the Pubocervical Fascia in Vesicovaginal Fistula Repair: A Retrospective Review.","authors":"Rachel Pope,&nbsp;Prakash Ganesh,&nbsp;Jeffrey Wilkinson","doi":"10.1155/2018/6396387","DOIUrl":"https://doi.org/10.1155/2018/6396387","url":null,"abstract":"<p><p>Urethral incontinence is an issue for approximately 10-15% of women with an obstetric fistula. Various surgical interventions to prevent this exist, including the pubococcygeal sling and refixation of the pubocervical fascia. Neither has been evaluated in comparison to one another. Therefore, this retrospective evaluation for superiority was performed. The primary outcome was urinary stress incontinence, and secondary outcomes were operative factors. There were 185 PC slings, but 12 were excluded because of urethral plications. There were 50 RPCF procedures, but 3 were excluded because of urethral plications. Finally, there were 32 cases with both PC sling and RPCF procedures. All groups demonstrated a higher than expected fistula repair rate with negative dye tests in 84% of the PC sling group, 89.9% in the RPCF group, and 93.8% in the RPCF and PC groups. There were no statistically significant differences found in continence status between the three groups. Of those who underwent PC slings, 49% were found to have residual stress incontinence. Of those who underwent RPCF, 47.8% had stress incontinence. Of those with both techniques, 43.8% had residual stress incontinence. Pad weight was not significantly different between the groups. As there is no statistically significant difference, we cannot recommend one procedure over the other as an anti-incontinence procedure. The use of both simultaneously is worth investigating.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"6396387"},"PeriodicalIF":1.9,"publicationDate":"2018-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/6396387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36741032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Accuracy of Episiotomy Incision in a Governmental Maternity Unit in Palestine: An Observational Study.","authors":"Hadil Y Ali-Masri,&nbsp;Sahar J Hassan,&nbsp;Kaled M Zimmo,&nbsp;Mohammed W Zimmo,&nbsp;Khaled M K Ismail,&nbsp;Erik Fosse,&nbsp;Hasan Alsalman,&nbsp;Åse Vikanes,&nbsp;Katariina Laine","doi":"10.1155/2018/6345497","DOIUrl":"https://doi.org/10.1155/2018/6345497","url":null,"abstract":"<p><p>Episiotomy should be cut at certain internationally set criteria to minimize risk of obstetric anal sphincter injuries (OASIS) and anal incontinence. The aim of this study was to assess the accuracy of cutting right mediolateral episiotomy (RMLE). An institution-based prospective cohort study was undertaken in a Palestinian maternity unit from February 1, to December 31, 2016. Women having vaginal birth at gestational weeks ≥24 or birthweight ≥1000 g and with intended RMLE were eligible (<i>n</i>=240). Transparent plastic films were used to trace sutured episiotomy in relation to the midline within 24-hour postpartum. These were used to measure incisions' distance from midline, and suture angles were used to classify the incisions into RMLE, lateral, and midline episiotomy groups. Clinical characteristics and association with OASIS were compared between episiotomy groups. A subanalysis by profession (midwife or trainee doctor) was done. Less than 30% were RMLE of which 59% had a suture angle of <40° (equivalent to an incision angle of <60°). There was a trend of higher OASIS rate, but not statistically significant, in the midline (16%, OR: 1.7, CI: 0.61-4.5) and unclassified groups (16.5%, OR: 1.8, CI: 0.8-4.3) than RMLE and lateral groups (10%). No significant differences were observed between episiotomies cut by doctors and midwives. Most of the assessed episiotomies lacked the agreed criteria for RMLE and had less than optimal incision angle which increases risk of severe complications. A well-structured training program on how to cut episiotomy is recommended.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"6345497"},"PeriodicalIF":1.9,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/6345497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36736549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Diagnostic Values among CA-125, RMI, HE4, and ROMA for Cancer Prediction in Women with Nonfunctional Ovarian Cysts.","authors":"Shina Oranratanaphan,&nbsp;Sinee Wanishpongpan,&nbsp;Wichai Termrungruanglert,&nbsp;Surang Triratanachat","doi":"10.1155/2018/7821574","DOIUrl":"https://doi.org/10.1155/2018/7821574","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance among CA-125, RMI, HE4, and ROMA for cancer detection in women with nonfunctional ovarian cysts at King Chulalongkorn Memorial Hospital (KCMH). Secondary objective is to reconsider the proper cutoff value of HE4.</p><p><strong>Methods: </strong>This is a prospective analytic study in women with nonfunctional ovarian cysts larger than 3 cm who scheduled for surgery at KCMH during 3^rd June 2015 to 31^st May 2016. Ultrasonogram and blood sample collection were completed before the operation. Patients' demographic information and pathologic results were obtained. SPSS software version 17 was used for statistical evaluation.</p><p><strong>Results: </strong>A total of 281 participants were evaluated. 19.9% of them were malignant. Compared with CA-125, HE4 had lower sensitivity (53.4% vs. 87.9%) and NPV (89% vs. 93.6%) but higher specificity (97.8% vs. 46.2%) and PPV (86.1% vs. 29.8%). ROMA had slightly lower sensitivity (79.3% vs. 87.9%) and similar NPV (93.7% vs. 93.6%), but higher specificity (79.8% vs. 46.2%) and PPV (50.5% vs. 29.8%) compared with CA-125. The model that achieves the highest area under the ROC curve in differentiating benign versus malignant ovarian tumor was ROMA. Cutoff value of HE4 at 70 pMol/L (from 150 pMol/L) would give sensitivity 74.1% and specificity 86.5% that are comparable with ROMA.</p><p><strong>Conclusions: </strong>HE4 and ROMA had better performance (higher specificity, PPV) compared to CA-125 and RMI. HE4 at 70 pMol/L could be the new cutoff value for Thai women with ovarian cysts, giving higher sensitivity and specificity.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"7821574"},"PeriodicalIF":1.9,"publicationDate":"2018-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/7821574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36653925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Experience of Women with Obstetric Fistula following Corrective Surgery: A Qualitative Study in Benadir and Mudug Regions, Somalia.","authors":"Adam A Mohamed,&nbsp;Abiodun O Ilesanmi,&nbsp;M David Dairo","doi":"10.1155/2018/5250843","DOIUrl":"https://doi.org/10.1155/2018/5250843","url":null,"abstract":"<p><p>Obstetric fistula is a severe maternal morbidity which can have devastating consequences for a woman's life and is generally associated with poor obstetric services leading to prolonged obstructed labour. The predisposing factors and consequences of obstetric fistula differ from country to country and from community to community. The World Health Organization estimated that more than 2 million women in sub-Saharan Africa, Asia, the Arab region, Latin America, and the Caribbean are living with the fistula, and some 50,000 to 100,000 new cases develop annually with 30,000-90,000 new cases developing each year in Africa alone. This study aimed at describing and exploring the experiences of women living with obstetric fistulas following corrective surgery in Benadir and Mudug regions, Somalia. Women living with obstetric fistula who had surgical repairs at Daynile and GMC fistula centers and key informants were identified purposively. Twenty-one individual in-depth interviews among women with obstetric fistula and eight key informant interviews were conducted. Thematic analyses were used. Codes were identified, and those codes with similar connections were organized together as to form themes. Detailed reading and rereading of the transcribed interviews were employed in order to achieve and identify themes and categories. Themes, categories, and subcategories illustrating the experiences of women living with obstetric fistula emerged from the thematic analysis of individual in-depth and key informant interviews. These were challenges of living with OBF which include \"wounds around genitalia, bad odour, incontinences of urine and feces, stigma, isolation, divorce, powerlessness, dependency, financial constraints, and loss of healthy years\" and coping mechanisms which include \"withdrawal from the community and improved personal hygiene.\" Women with obstetric fistula experience serious health and social consequences which prevents them fulfill social, family, and personal responsibilities. We recommend expansion of BEmONC services to underserved areas, capacity building for local OBF surgeons, and improved media campaign and birth preparedness at community levels.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"5250843"},"PeriodicalIF":1.9,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/5250843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36609582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}