Childbirth-Associated Fistula and Perineal Tears Repaired on Outreach Campaigns in Remote Democratic Republic of Congo

2021-11-01 | Télécharger

BACKGROUND :

Childbirth is relatively safe in the developed world; however, in developing countries many disparities in health outcomes and maternal complications exist. According to the WHO (2017) the lifetime risk of maternal death is as high as 1 in 45 in low-income countries, compared to 1 in 5400 in high income countries. In 2017, 295,000 women died following childbirth; Sub-Saharan Africa alone accounting for 196,000 of these deaths.1 Although there have been reductions in overall maternal mortality since 2000, there remain significant challenges.

Vesicovaginal fistulas are predominant among childbirth-associated injuries encountered in remote DRC. While their leading cause was vaginal delivery, iatrogenic errors caused nearly half of identified injuries. Cure rate of fistulas and perineal tears is high during outreach campaigns; however, outcomes were poorer the longer the patient waited for repair. There is a need to train, mentor and support medical professionals working in remote DRC. There is need to train, mentor and continuously supervise medical professionals working in remote DRC on adequate management of obstetric emergencies. A lack of skilled professionals appears to be one of the underlying causes of childbirth injuries.