Determinants of risk factors for the development of obstetric fistula in a national fistula centre of a tertiary care medical college hospital

Sukla Nath; Surajit Dutta; Riasona Ferdous; Ataul Karim; Quazi Aysha Siddiqua; Musarat Shameem; Rojy Siddiqee; Iffat Ara

doi:10.18203/2320-1770.ijrcog20251948

Authors

Sukla Nath Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Surajit Dutta Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
Riasona Ferdous Government Homeopathic Medical College, Dhaka, Bangladesh
Ataul Karim Hospital Services Management, DGHS Dhaka, Bangladesh
Quazi Aysha Siddiqua Department of Medicine, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Musarat Shameem Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Rojy Siddiqee Upazila Health Complex, Chattogram, Bangladesh
Iffat Ara Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251948

Keywords:

Obstetric fistula, Early marriage, Malnutrition, Antenatal care, Unskilled birth attendants

Abstract

Background: Obstetric fistula is a debilitating condition caused by prolonged, obstructed labor without timely medical care, creating an abnormal opening between the birth canal and bladder or rectum. It remains prevalent in developing regions, particularly South Asia and Africa, due to early marriage, poor maternal healthcare, and lack of skilled birth attendants. In Bangladesh, obstetric fistula is both a medical and social burden, demanding targeted public health interventions. Objectives were to identify the risk factors and patient profile associated with obstetric fistula among women attending the national fistula centre, Dhaka medical college hospital (DMCH), Dhaka, Bangladesh.

Methods: This case-control study was conducted in the department of obstetrics and gynaecology at DMCH from July to December 2010. A total of 50 confirmed obstetric fistula cases were selected using purposive sampling. Data were collected via structured questionnaires and clinical examination. Inclusion and exclusion criteria were strictly followed. Data analysis was done using SPSS software. Ethical approval and informed consent obtained before initiating study.

Results: Among respondents, 34% were aged 31-35 years. In control group, 82% were aged 21-30. Inhabitants: 66% urban in control, 76% rural in case group. Education: 64% control crossed SSC; 42% case were illiterate. Labour pain >24 h in 94% cases. Home trial >24 h in 92% cases. Delivery by Dai: 87.5% in cases. Caesarean section: 58% in cases vs 6% in control. Assisted deliveries: 84.62% in cases.

Conclusions: Early marriage, poor health behavior, malnutrition, and lack of ANC contribute to obstetric fistula, with delayed hospital visits.

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