Obstetric fistula in India: current scenario.
BACKGROUND
India lacks prevalence and incidence data on obstetric fistula, a near miss maternal mortality.


METHODS
Retrospective data were collected on obstetric fistula cases from hospital records of 24 tertiary care facilities during the period 2000-2006.


RESULTS
Overall, 717 women underwent genital fistula repair, but medical records could be retrieved for only 401 (56%) cases. States of Bihar, Uttar Pradesh, and West Bengal had more than 100 cases each, while Karnataka had none. Obstructed labor caused nearly 97% of genital fistulae while pelvic surgery and accidental trauma contributed to 1.5% cases each. Commonest type of fistula was genitourinary (86.6%), others included rectovaginal (12.1%) and both genitourinary and rectovaginal fistulae (1.2%). Fistula repair was attempted in 322 (83%) cases of whom 289 (89.71%) were successfully repaired.


CONCLUSIONS
There is a need for ongoing systematic data collection mechanism like a fistula registry that would provide facility-based prevalence and incidence, time trends, and changes in etiology of fistula. This information could be used for implementation of prevention and treatment strategies.
Division of Reproductive Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India. shalinisingh_icmr@yahoo.co.in
Shalini
S
Singh
Nomita
N
Chandhiok
Balwan
B
Singh Dhillon
D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D014624:Vaginal Fistula / Q000453:epidemiology*