Abstract:
Obstetric fistula is a devastating form of maternal morbidity. It is characterized by an
abnormal communication between the vagina and the lower urinary/ gastrointestinal
structures or both. It is a result of injury due to pregnancy and its related complications
with the resultant effect of continuous leakage of urine or faeces or both into the
vagina. It remains a problem in Africa. This study sought to identify predisposing
factors to obstetric fistula among women seeking care in the Tamale metropolis. In this
matched case control study, cases were from the Tamale fistula center. Controls were
matched on the year of delivery, region and district of index delivery. A total of 151
participants made up of 51 cases and 100 controls participated. This study identified
three major factors for obstetric fistula; age below 20 years, total labour duration more
than 24 hours and height 150 cm and below. It further identified four minor factors
which are still birth, delivery by caesarean section, residence in a rural area and lack of
formal education. Across both study groups, there is lack of adequate knowledge about
obstetric fistula. Findings in this study agree with the literatures that, majority of
women who suffer obstetric fistula are young, poor, illiterate, of short stature, resident
in remote areas and labour more than 24 hours. Based on the associated factors, an
obstetric fistula forecast score (OFFSCORE) was proposed, which is composed of
three major criteria, the presence of each which is scored 2 and zero otherwise and four
minor criteria each scored one and zero otherwise. A total OFFSCORE of four and
above classified as high risk has a sensitivity of 90.2% and a specificity of 86.0% for
predicting obstetric fistula. This study recommends immediate prophylactic urethral
catheterization for high risk for obstetric fistula post-partum women.
