Singh Shalini, Chandhiok Nomita, Singh Dhillon Balwan
Division of Reproductive Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1403-5. doi: 10.1007/s00192-009-1000-0. Epub 2009 Sep 30.
India lacks prevalence and incidence data on obstetric fistula, a near miss maternal mortality.
Retrospective data were collected on obstetric fistula cases from hospital records of 24 tertiary care facilities during the period 2000-2006.
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.
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.
印度缺乏关于产科瘘管病（一种接近孕产妇死亡的情况）的患病率和发病率数据。
收集了2000 - 2006年期间24家三级医疗设施的医院记录中产科瘘管病例的回顾性数据。
总体而言，717名妇女接受了生殖瘘修补术，但仅检索到401例（56%）的病历。比哈尔邦、北方邦和西孟加拉邦各有100多例病例，而卡纳塔克邦没有病例。产程梗阻导致了近97%的生殖瘘，而盆腔手术和意外创伤各占1.5%的病例。最常见的瘘管类型是泌尿生殖瘘（86.6%），其他包括直肠阴道瘘（12.1%）以及泌尿生殖瘘和直肠阴道瘘两者并存（1.2%）。322例（83%）病例尝试进行了瘘管修补，其中289例（89.71%）成功修复。
需要建立持续的系统数据收集机制，如瘘管登记处，以提供基于机构的患病率和发病率、时间趋势以及瘘管病因的变化。这些信息可用于实施预防和治疗策略。
