Selected Clinical Characteristics and Determinants of Obstetric Palsy Among Patients With Obstetric Fistula

Abstract

Background: Obstetric fistula is a major maternal health issue with its attendant physical, psychosocial, and economic correlates. The morbidity worsens with physical challenges associated with neurological and musculoskeletal injury in the patient. Objectives: The major objective of this study was to examine selected clinical characteristics and determinants of obstetric palsy among patients with obstetric fistula. Study Design: Descriptive retrospective study. Methods: Medical records of 452 patients who were treated for obstetric fistula at the National Obstetric Fistula Centre, Abakaliki, from January 2014 to May 2018 were retrieved and analyzed for clinical characteristics and clinical determinants using the SPSS for Windows (SPSS version 20). Results: Results revealed that 23.5% of the subjects neither registered for nor attended antenatal care in a health facility. While 50.9% of the subjects had lived with fistula for less than a year, 31.4% lived with obstetric fistula between 1 and 9 years. Labor lasting for 2 days or more was reported by 46.7%. Vaginal births were reported by 34.1%. Intracervical fistula was the most frequently encountered fistula. Maternal obstetric paralysis of one or both lower limbs was found in 31.4% of the subjects. Results of a binary logistic regression model also reveals that antenatal care, duration of labor, mode of delivery, and circumferential fistula were significant determinants of obstetric palsy among patients with obstetric fistula. Conclusion: There is need to increase public enlightenment and make antenatal care and delivery readily available to reduce obstetric fistula and maternal obstetric palsy. Therapists' awareness of these determinants also aids in clinical diagnosis, prognosis, and prevention.