Musculoskeletal sequelae in patients with obstetric fistula - a case-control study

Area of Science:

• Obstetrics and Gynecology
• Musculoskeletal Health
• Public Health

Background:

• Obstetric fistula results from severe pelvic trauma during prolonged obstructed labor.
• Associated musculoskeletal injuries, like foot drop and walking difficulties, are under-researched.
• This study investigates the extent of pelvic injury sequelae in women with obstetric fistula.

Purpose of the Study:

• To assess the musculoskeletal function in women with obstetric fistula.
• To understand the broader impact of pelvic trauma beyond fistula formation.
• To evaluate differences in joint mobility, muscle strength, and pain between cases and controls.

Main Methods:

• A case-control study comparing 70 women with obstetric fistula to 100 matched controls.
• Data collected included height, weight, walking difficulties, pain, muscle strength, joint range of motion, circumference, and reflexes.
• Statistical analysis used independent sample t-tests and chi-square tests.

Main Results:

• Women with obstetric fistula reported more leg pain (20% vs 7%) and walking difficulties (29% vs 0%).
• Cases showed reduced ankle and knee range of motion but increased hip extension, lateral rotation, and abduction.
• Reduced ankle strength and foot drop were observed in 12% and 4.3% of cases, respectively.

Conclusions:

• Obstetric fistula is frequently associated with post-delivery walking difficulties and leg pain.
• Ankle and knee joint function are commonly reduced in women with fistula.
• Compensatory increases in hip motion and strength may occur following obstetric fistula-related pelvic trauma.