scholarly journals Obstetric Fistula and Common Peroneal Nerve Palsy in a Rural Based Women: A Case Report

2015 ◽  
Vol 14 (1) ◽  
pp. 71-73
Author(s):  
Suchanda Das ◽  
Rokeya Begum ◽  
Bidhan Roy Chowdhury
Keyword(s):  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Common Peroneal Nerve ◽  
Home Delivery ◽  
Obstructed Labor ◽  
Labor Ward ◽  
Comprehensive Health ◽  
Common Peroneal Nerve Palsy ◽  
Maternal And Newborn

Neglected obstructed labor is a major cause of both maternal and newborn morbidity and mortality. By far the most severe and distressing long term morbidity following obstructed labor is obstetric fistula i.e. Vesicovaginal fistula. In developing countries fistula is commonly the result of prolonged obstructed labor. A18 year old primi gravida was admitted in the labor ward with the involuntary passage of stool and urine and unable to walk after 15 days of her home delivery. Temporary colostomy was done. Patient was on regular physiotherapy for prolonged time and she was responded slowly. There was a plan for repair of Vesicovaginal and Rectovaginal fistula. Obstructed labor complex is completely preventable if high quality basic and comprehensive health services are available to all. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22891 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 71-73

scholarly journals Vesicovaginal Fistula (VVF): Success of primary repair.

2019 ◽  
Vol 26 (12) ◽  
pp. 2090-2094
Author(s):  
Robina Ali ◽  
Ghazala Niaz ◽  
Riffat Ehsan
Keyword(s):  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Primary Repair ◽  
Tertiary Care ◽  
Home Delivery ◽  
Care Hospital ◽  
Fistula Repair ◽  
Operative Care ◽  
Ureteric Orifice ◽  
Quasi Experimental

Objectives: The main objective of this research is to determine success of primary repair of vesicovaginal fistula at tertiary care hospital. Study Design: Quasi Experimental. Setting: DHQ Hospital, Faisalabad, Obstetrics and Gynaecology Department. Period: From Mar 2015 to Mar 2017. Material & Method: 15 patients were enrolled by consecutive sampling and those having fistulas more than 4cm or involving ureteric orifice, bladder neck or urethra were excluded. After proper history examination, preliminary investigations and EUA, fistula repair was done. All information recorded on proposed proforma for this purpose. Results: Among all 15 patients, 10(66.7%) were having obstetric fistulas and 5(33.3%) were with non obstetric fistula. 07 (46.7%) had home delivery, 3(20%) had delivery at center by untrained persons, 3(20%) had hysterectomy by untrained surgeons i.e. 1(6.7%) for endometriosis, 1(6.7%) for multiple fibroids and 1(6.7%) for ovarian malignancy while 2(13.3%) patients had inducted miscarriages by midwives. 12 (80%) patients had subtrigonal and trigonal fistulas, so underwent transvaginal repair and rest 3(20%) had supratrigonal fistula so transabdominal repair was done. Success of repair was 93.3% (14) and 1 was complicated with failed fistula repair. Conclusion: Most fistulas encountered in this study were caused by obstetrics trauma and are preventable. In existing cases of vesicovaginal fistula, properly trained health professionals with impeccable evaluation, prudent decision about route and technique of repair and good post operative care are key points in success of surgical repair.  

scholarly journals Vesicouterine Fistula in Burkina Faso: Report of 36 Cases in a Multicentric Study

2021 ◽  
Vol 2 (4) ◽  
pp. 210-215
Author(s):  
Boureima Ouedraogo ◽  
Brahima Kirakoya ◽  
Moussa Kabore ◽  
Adama Millogo ◽  
Adama Ouattara ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Burkina Faso ◽  
Success Rate ◽  
Vaginal Delivery ◽  
Medical Records ◽  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Emergency Caesarean Section ◽  
Obstructed Labor ◽  
Multicentric Study

Objective: To report etiological and therapeutic features of vesicouterine fistulas (VUF) in Burkina Faso. Patients and Methods: We performed a retrospective, descriptive, and multicentric study based on the medical records of women treated for VUF from January 2010 to December 2016. Results: VUF accounted for 7.2% (36/497) of urogenital fistulas managed during the study period. The median age of the 36 patients was 35 years (interquartile range = 27 to 37.5 years) with values ranging from 16 years to 64 years old. Among VUF, obstetric fistula accounted for 26 cases (26/36) versus 10 cases (10/36) of iatrogenic fistula. Obstetric VUF were consecutive to emergency Caesarean section (n = 16) and vaginal delivery (n = 10) after prolonged obstructed labor. The 10 cases of iatrogenic VUF were subsequent to prelabour Caesarean section. The main circumstance of VUF occurrence was Caesarean section (26/36). In 10 cases (10/36), VUF was associated with a vesicovaginal fistula. Thirty days after the removal of the catheter, the success rate fell from 89% to 80.6%. Conclusion: VUF is rare but its frequency is not negligible in our context. The main circumstance of occurrence remains Caesarean section. The best treatment remains prevention.

scholarly journals Outcome and predictors of surgical repair of obstetric vesicovaginal fistula in a teaching hospital in ethiopia: retrospective cohort study

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Demisew Amenu ◽  
Ahadu Workineh ◽  
Desta Hika
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vesicovaginal Fistula ◽  
Surgical Repair ◽  
Obstetric Fistula ◽  
Success Rates ◽  
Fistula Repair ◽  
Obstructed Labor ◽  
Cohort Study Design

Aims: To determine outcomes of obstetric fistula repair and predictors of outcomes among patients with obstetric vesicovaginal fistula. Methods: A Hospital based Retrospective Cohort study design was conducted on all patients with Obstetric vesicovaginal Fistula, who were admitted to Gynecology ward, and had surgical repair from January 2011 to December 2014. Data was collected from patients’ chart, operation logbook and discharge logbook which were filled up from the entry of the patient to the hospital till her discharge. At discharge, a dye test was done to determine the outcome of repair. Results: 168 patients with obstetric vesicovaginal fistula were repaired during the study period. The age of the women ranged from 12 to 45 years with mean of 25 (± 6) years. Eighty percent of patients were laboring for two or more days, 46.4% delivered abdominally, and 85.7% ended up in stillbirth. Out of 93.4% patients who had successful closure of their fistula, 84.5% of patients had their fistula healed and continent, 8.9 % of them developed urinary incontinence while 6.5% of fistula repair had failed at the time of discharge. Unsuccessful fistula repair was significantly associated with being divorced/widowed (AOR 2.65 95%CI 1.06,6.67), Moderate/severe vaginal scaring (AOR5.25 95% CI 2.19, 12.60). Conclusions: In this study most fistula patients are older than 18 years, referred from health centers either for cephalopelvic disproportion or obstructed labor after prolonged labor at home, high success rates were achieved with surgical repair, and being divorced /widowed and marked vaginal scarring are predictors for unsuccessful fistula repair. Therefore, increasing access to comprehensive emergency obstetric and new born care is essential to minimize the delay contributing to perinatal mortality and obstetric fistula.

Common Peroneal Nerve Palsy After Grade I Inversion Ankle Sprain

2012 ◽  
Vol 21 (04) ◽  
pp. 261-265 ◽  
Author(s):  
Evanthia A. Mitsiokapa ◽  
Andreas F. Mavrogenis ◽  
Dimitris Antonopoulos ◽  
George Tzanos ◽  
Panayiotis J. Papagelopoulos
Keyword(s):  
Ankle Sprain ◽  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Palsy ◽  
Common Peroneal Nerve Palsy

scholarly journals Comparative Study of Intrathecal Low Dose Bupivacaine and Fentanyl Versus Conventional Dose of Hyperbaric Bupivacaine for Cesarean Section

2018 ◽  
Vol 9 (1) ◽  
pp. 57-62
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Sirajul Islam ◽  
Sharmin Abbasi
Keyword(s):  
Rural Women ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Home Delivery ◽  
Personal Hygiene ◽  
Antenatal Visit ◽  
Hyperbaric Bupivacaine ◽  
Obstructed Labor ◽  
Cross Sectional ◽  
Mortality And Morbidity

Background: Pregnancy and childbirth related complications are the leading causes of maternal mortality and morbidity in Bangladesh. An estimate shows that about 28,000 mothers die in each year in Bangladesh due to obstetric complications. The aim of this study was to find out the birth practice among rural women in Bangladesh.Material and Methods: This descriptive cross sectional study was carried out among 1220 respondents by purposive sampling technique from July 2016 to June 2017 in different Private Hospital, Dhaka. Data were collected by a structured questionnaire duly pretested through face to face interview. Data were analyzed manually and by using computer.Results: Then study revealed that majority of the respondents 80% were Muslims by religion and about 26% respondents were found within the age 25-29 years with mean age 31±7.59 years. Most of them 86% were literate and only 14% were found illiterate. Among the respondents 75% were Housewives and 11%, 9%, 1% and 4% were involved in Service, Business, Agriculture and others occupation respectively. Moreover, 78% respondents monthly income were less than TK 3000. About 43% & 16% respondents were found to have 2 & 3 children respectively. In this study, about 73% received antenatal visit and among them 57% received 1 to 3 antenatal visits and 74% received TT immunizations. It was found that 69%, 54% and 59% received antenatal advices on healthy diet, personal hygiene, drug use respectively. Home delivery and Hospital delivery practice were found among 44% & 56% respondents respectively. The reasons for home delivery like Feeling comfortable, Family decision and Financial problem were found in 60%, 26% & 42% respondents respectively. The most common complications during last delivery were obstructed labor, found among 39% respondents.Conclusion: Still now women prefer home delivery. Major reasons for home delivery were Feeling comfortable, Family decisions and Financial problems. Delivery conduction by qualified doctors were found only among 47% women. Efforts needed to increase maternal health related knowledge and awareness towards birth practice to facilitate decision in minimizing complications and mortality.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 57-62

The ‘occiput-spine angle’: a new sonographic index of fetal head deflexion during first stage of labor as predictor of course of labor and outcome

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham Mohammed Fathy ◽  
Ahmed Mohammed Bahaa El-Din ◽  
Haitham Fathy Mohammed ◽  
Mohammed Mahmoud Mohammed Helmy
Keyword(s):  
Maternity Hospital ◽  
Ultra Sound ◽  
Operative Delivery ◽  
Fetal Head ◽  
Obstructed Labor ◽  
Uterine Contractions ◽  
Labor Ward ◽  
Vaginal Deliveries ◽  
Fetal Complications ◽  
First Stage Of Labor

Abstract Background Labor is a physiologic process during which the products of conception (i.e. the fetus, membranes, umbilical cord, and placenta) are expelled outside of the uterus. Labor is achieved with changes in the biochemical connective tissue and with gradual effacement and dilatation of the uterine cervix as a result of rhythmic uterine contractions of sufficient frequency, intensity, and duration. Labor is divided into three stages that include cervical dilatation, fetal delivery and delivery of the placenta. Objective The aims of this study were to quantify the degree of fetal head deflection via the use of Ultrasound during the first stage of labor and to determine whether a parameter derived from ultrasound examination (the occiput-spine angle) has a relationship with the progress of labor, subsequent effect on maternal, fetal complications and rate of cesarean delivery. Methods This is a prospective cohort study which includes a total of 200 women with gestational age 37-42 weeks were assessed in this study in Ain shams Maternity hospital labor ward by 2 dimensional ultra sound. Examinations were performed after a verbal and written consent from the patient with the patient lying in the dorsal supine position. And exclusion of Occiput-posterior position, multigravida, Indication for cesarean, Medical disorder eg hypertension or diabetes, pre labor rupture of membranes to correlate between the Occiput- spine angle (OSA) and the outcome of labor regarding the progress of labor, incidence of cesarean section, maternal and fetal complications. Results This study demonstrates that the sonographic measurement of the angle formed by the fetal occiput and the spine (occiput-spine angle) is feasible and reproducible, the occiput-spine angle in the first stage of labor is positively correlated with the clinically established station and the risk of obstructed labor requiring an operative delivery ie, Occiput-spine angle have been statistically significantly lower in cases underwent operative delivery. Occiput-spine angle had a statistically significant low diagnostic performance in predicting operative delivery. Conclusion The occiput-spine angle in the first stage of labor correlates significantly with the risk of obstructed labor Compared with spontaneous vaginal deliveries, cases that require obstetric intervention demonstrated a smaller occiput-spine angle at a similar station, suggesting diminished flexion of the fetal head. For occiput anterior fetuses, the greater the degree of fetal head deflexion, the greater risk of operative delivery due to labor arrest.

scholarly journals Pregnancy after Obstetric Fistula: Should It Be Encouraged?

2018 ◽  
Vol 13 (3) ◽  
pp. 56-58
Author(s):  
Ranjana Shrestha ◽  
Kenusha Devi Tiwari ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
...  
Keyword(s):  
Obstetric Fistula ◽  
Mode Of Delivery ◽  
Public Health Problem ◽  
Successful Outcome ◽  
Elective Cesarean Section ◽  
Major Public Health Problem ◽  
Fistula Repair ◽  
Obstructed Labor ◽  
Operative Care ◽  
Elective Cesarean

Obstetric fistula (OF) is a life-changing morbidity associated with childbirth. It occurs especially after a prolonged obstructed labor and is a major public health problem in the developing countries. The smell of stool and urine leads to the ostracization and rejection of fistula patients by their spouses, families, friends and society in whole. Surgical treatment of fistula is possible. However, this successful outcome of fistula repair surgery is dependent on pre-operative care and the post-operative care such as delaying the commencement of sexual intercourse and delaying conception. Family planning can aid to this. Pregnancy is advised after minimum of 12 months’ post-repair and mode of delivery should be elective cesarean section. Here, we present a case of 23 years’ female, who suffered from obstetric fistula who underwent obstetric fistula repair twice, re-married and conceived after a year with successful elective cesarean delivery.

scholarly journals Long-Term Survival is Possible After Stenting for Malignant Ureteric Obstruction in Colorectal Cancer

2007 ◽  
Vol 89 (4) ◽  
pp. 414-417 ◽  
Author(s):  
Oliver M Jones ◽  
Solomon KP John ◽  
Richard J Lawrance ◽  
J Basil J Fozard
Keyword(s):  
Colorectal Cancer ◽  
Vesicovaginal Fistula ◽  
Urinary Tract Obstruction ◽  
Ureteric Obstruction ◽  
Clinical Coding ◽  
Term Survival ◽  
Recurrent Tumour ◽  
Long Term Survival ◽  
Colorectal Surgeons

INTRODUCTION Ureteric obstruction is a potentially terminal event in patients with irresectable or recurrent colorectal cancer. Urinary tract obstruction is easily relieved by either two stage antegrade stenting or one stage retrograde stenting. However, there is little in the literature about outcomes after this procedure and it is unclear which, if any, patients should be offered this intervention. PATIENTS AND METHODS This was a retrospective review of a prospectively collected database of patients diagnosed with colorectal cancer. This database comprised 1428 cases (operative and non-operative) diagnosed at a single institution. This was cross-checked with databases for patients undergoing nephrostomy and/or antegrade stenting and by clinical coding for those patients having retrograde stenting between January 1996 and October 2004. RESULTS Thirteen patients were identified (median age, 69 years: range, 35–85 years; 9 male). The aetiology of obstruction was recurrent tumour in 6 patients and irresectable tumour in the remaining 7 patients. Two patients were discussed at a urology multidisciplinary meeting before stenting and a further two were discussed with colorectal surgeons. One patient received a palliative cystectomy and ileal conduit for a vesicovaginal fistula followed by radiotherapy. Four patients received chemotherapy after stenting. Overall median survival was 210 days (range, 13–927 days). CONCLUSIONS Long-term survival is possible in selected patients with recurrent or irresectable colorectal cancer and malignant ureteric obstruction. This appears to be more likely in those patients in whom other treatments, particularly chemotherapy, are available.

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