Reem S Abu-Rustum, Margarita Berwick, Jessica Heft
Successful Implementation of the AIUM Standardized 4-Year Residency Ultrasound Curriculum in Obstetrics and Gynecology: Lessons Learned and Way Forward
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
global cesarean section rates rising theres concern increase obstetric vesicouterine fistula ovuf little known anatomoclinical entity obstetric fistula africa general drc particular purpose describe epidemiological clinical therapeutic aspects ovuf democratic republic congo drc descriptive crosssectional study data collected patients presented ovuf across seven provinces drc north kivu hautul kasai central kwilu maniema nordubangi sankuru january 2017 december 2022 study variables epidemiological clinical therapeutic features 1267 patients presenting obstetric fistulas 355 280 ovuf mean age 329 116 years 806 patients 286355 lived rural areas majority low level education 40 formal education 301 primary school 287 secondary school total 648 patients primiparous 230355 100 cases ovuf caused iatrogenically cesarean delivery majority 763 patients laboured one day less mean duration 10 05 days giving birth fetus died 583 cases 358 cases fistula lasted 10 years mean age 101 100 years repair proportion 882 n 313 ovuf isolated 113 n 40 associated ureterovaginal fistula 828 n 294 cases ovuf single average fistula size 24 10 cm range 05 55 cm 274 772 fistulas measured 15 3 cm 149 n 53 larger 3 cm fibrosis present 651 cases cervical involvement absent 977 postoperative complications absent 944 cases ovuf surgically repaired abdominally success rate 975 346355 proportion ovuf relatively high drc affected patients young undereducated primiparous women living rural areas cesarean section sole identified cause ovuf isolated single without fibrosis majority cases abdominal repair ovuf effective good results almost cases teaching young doctors working mainly remote areas perform safe cesarean section needed reduce incidence ovuf drc