The obstetric vesicovaginal fistula: characteristics of 899 patients from Jos, Nigeria.
OBJECTIVE
The purpose of this study was to describe the characteristics of women with obstetric vesicovaginal fistulas at a hospital in north central Nigeria.


METHODS
A retrospective record review was conducted of all women who were seen with vesicovaginal fistulas at Evangel Hospital in Jos, Plateau State, Nigeria, between January 1992 and June 1999.


RESULTS
A total of 932 fistula cases were identified, of which 899 cases (96.5%) were associated temporally with labor and delivery. The "typical patient" was small and short (44 kg and <150 cm); had been married early (15.5 years) but was now divorced or separated; was uneducated, poor, and from a rural area; had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus.


CONCLUSIONS
Obstetric vesicovaginal fistula is extremely common in north central Nigeria. A complex interaction that involves multiple biologic and socioeconomic factors appears to predispose young women to this devastating childbirth injury.
Wall
L Lewis
LL
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA. WALLL@msnotes.wustl.edu
Karshima
Jonathan A
JA
Kirschner
Carolyn
C
Arrowsmith
Steven D
SD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014719:Vesicovaginal Fistula / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control