EngenderHealth, Kinshasa, République Démocratique Congo.
Hôpital Saint Joseph, Kinshasa, République Démocratique Congo.
Trop Med Int Health. 2020 Jun;25(6):687-694. doi: 10.1111/tmi.13394. Epub 2020 May 8.
To describe the frequency, causes and post-repair outcomes of NOF in hospitals supported by the Fistula Care Plus (FC+) project in the Democratic Republic of Congo.
Retrospective cohort study from 1 January 2015 to 31 December 2017 in three FC + supported fistula repair sites.
Of 1984 women treated for female genital fistula between 2015 and 2017 in the three FC + supported hospitals, 384 (19%) were considered to be non-obstetric fistula (NOF) cases. 49.3% were married/in a relationship at the time of treatment vs. 69% before the fistula, P < 0.001. Type III (n = 247; 64.3%) and type I (n = 121; 31.5%) fistulas according to Kees/Waaldijk classification were the most common. The main causes of NOF were medical procedure (n = 305; 79.4%); of these, caesarean section (n = 234; 76.7%) and hysterectomy (n = 54; 17.7%) were the most common. At hospital discharge, the fistula was closed and dry in 353 women (95.7%).
Non-obstetric fistula, particularly due to iatrogenic causes, was relatively common in the DRC, calling for more prevention that includes improved quality of care in maternal health services.
描述刚果民主共和国 fistula care plus (FC +) 项目支持的医院中非产科瘘（NOF）的频率、原因和修复后结果。
这是一项 2015 年 1 月 1 日至 2017 年 12 月 31 日在三个 FC + 支持的瘘管修复点进行的回顾性队列研究。
在 2015 年至 2017 年期间，在三个 FC + 支持的医院中治疗的 1984 名女性生殖道瘘患者中，有 384 例（19%）被认为是非产科瘘（NOF）病例。治疗时，49.3%的患者已婚/有伴侣，而瘘管发生前，这一比例为 69%，P < 0.001。根据 Kees/Waaldijk 分类，III 型（n = 247；64.3%）和 I 型（n = 121；31.5%）瘘管最常见。NOF 的主要原因是医疗程序（n = 305；79.4%）；其中，剖宫产（n = 234；76.7%）和子宫切除术（n = 54；17.7%）最为常见。在出院时，353 名女性（95.7%）的瘘管已闭合且干燥。
在刚果民主共和国，非产科瘘，特别是由于医源性原因导致的非产科瘘比较常见，这需要更多的预防措施，包括改善孕产妇保健服务的质量。
