n South African Journal of Obstetrics and Gynaecology - Obstetric urinary fistulas in KwaZulu-Natal - what is the extent of this tragedy?




This study describes the demographics and clinical characteristics of women with obstetric fistulas attending the urogynaecological unit at King Edward VIII Hospital (KEH), KwaZulu-Natal (KZN), South Africa.

A prospective clinical review of all women admitted with the diagnosis of an obstetric fistula at KEH from 1999 to 2003.
A total of 41 cases from the rural areas of KZN and the Eastern Cape were identified. The mean age was 29 years (range 15 - 51 years), and 21 were primigravidas, 14 of whom had unplanned pregnancies. All were from low socioeconomic backgrounds and had limited or no access to antenatal care, either due to their social circumstances or to lack of health care facilities. The duration of labour was prolonged in all; there were 5 live births, and 2 neonatal deaths.
Obstetric fistulas are still common in KZN and the Eastern Cape, and occur mainly in women from rural areas.


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