{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:08:28Z","timestamp":1779912508765,"version":"3.53.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":183,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objectives.<\/jats:italic> Obstetric fistulas are severe sequelae of prolonged obstructed labor, a widespread but incompletely documented problem of low\u2010income countries. Here, we characterize women with obstetric fistula, test the hypothesis that primi\u2010 and multipara represent different profiles and that fetal size is an important factor in developing fistula. <jats:italic>Design.<\/jats:italic> Hospital registry statistics and questionnaire. <jats:italic>Population.<\/jats:italic> A total of 14,928 Ethiopian women with obstetric fistula in 1974\u20132006 and 434 admitted in 2007\u20138. <jats:italic>Methods.<\/jats:italic> Self\u2010reported age, marital status, education, distance from home to health facility, parity, duration of labor, neonatal outcome and sex, lag time to treatment; measurement of weight, stature, extent of lesion and clinical assessment of continence before hospital discharge. <jats:italic>Outcome measures.<\/jats:italic> Duration of labor, extent of pelvic injury and neonatal survival, cure rate. <jats:italic>Results.<\/jats:italic> Primi\u2010 were more common than multiparous cases (56.8 vs. 43.2%). They were of similar age at marriage (17 years) and stature at hospital admission, but shorter than the population average (152.7 vs. 156.5 cm). Primipara had longer labor than multipara (50.5% &gt; 3 days vs. 27%), larger uro\u2010vaginal fistula, more stillbirths (95 vs. 88%), recto\u2010vaginal fistula, vaginal scarring, persistent incontinence after repair and were more commonly divorced. Male fetuses were involved in 76.7% of obstructed deliveries but in only 44.6% of a previous uneventful delivery in multipara. Educational attainment positively influenced outcomes. <jats:italic>Conclusions.<\/jats:italic> Obstetric fistula is more commonly associated with primiparous than subsequent pregnancies. Primipara have a longer and more damaging labor. A causative role for cephalo\u2010pelvic disproportion is supported by the observation that male fetuses are more commonly involved in obstructed labor.<\/jats:p>","DOI":"10.3109\/00016341003801698","type":"journal-article","created":{"date-parts":[[2010,4,16]],"date-time":"2010-04-16T12:41:37Z","timestamp":1271421697000},"page":"945-951","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Obstetric fistula in 14,928 Ethiopian women"],"prefix":"10.1111","volume":"89","author":[{"given":"MULU","family":"MULETA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SVEIN","family":"RASMUSSEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TORVID","family":"KISERUD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,31]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"Maternal Mortality in 2005. 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