Toward a complete estimate of physical and psychosocial morbidity from prolonged obstructed labour

A modelling study based on clinician survey

Bibliographic Data

ID21878837
AuthorsLina Roa (0000-0001-6552-4452, Harvard University, corresponding author), Luke Caddell (Harvard University), Gabriel Ganyaglo (0000-0002-1840-755X, Korle Bu Teaching Hospital), Vandana Tripathi (0000-0002-8237-342X, EngenderHealth), Nazmul Huda (0000-0003-0205-0485, EngenderHealth Inc, Dhaka, Bangladesh), Lauri J Romanzi (0000-0002-8042-7455, EngenderHealth), Lauri Romanzi (Harvard Medical School), Blake C Alkire (Massachusetts Eye and Ear Infirmary)
Year2020
Volume5
Issue7
Pagese002520
Publication date2020-07-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2020-002520
PMID32636314
OpenAlexW3038905630
LanguageEN
Citations received1
References cited37

INTRODUCTION: Prolonged obstructed labour often results from lack of access to timely obstetrical care and affects millions of women. Current burden of disease estimates do not include all the physical and psychosocial sequelae from prolonged obstructed labour. This study aimed to estimate the prevalence of the full spectrum of maternal and newborn comorbidities, and create a more comprehensive burden of disease model. METHODS: This is a cross-sectional survey of clinicians and epidemiological modelling of the burden of disease. A survey to estimate prevalence of prolonged obstructed labour comorbidities was developed for prevalence estimates of 27 comorbidities across seven categories associated with prolonged obstructed labour. The survey was electronically distributed to clinicians caring for women who have suffered from prolonged obstructed labour in Asia and Africa. Prevalence estimates of the sequelae were used to calculate years lost to disability for reproductive age women (15 to 49 years) in 54 low- and middle-income countries that report any prevalence of obstetric fistula. RESULTS: Prevalence estimates were obtained from 132 participants. The median prevalence of reported sequelae within each category were: fistula (6.67% to 23.98%), pelvic floor (6.53% to 8.60%), genitourinary (5.74% to 9.57%), musculoskeletal (6.04% to 11.28%), infectious/inflammatory (5.33% to 9.62%), psychological (7.25% to 24.10%), neonatal (13.63% to 66.41%) and social (38.54% to 59.88%). The expanded methodology calculated a burden of morbidity associated with prolonged obstructed labour among women of reproductive age (15 to 49 years old) in 2017 that is 38% more than the previous estimates. CONCLUSIONS: This analysis provides estimates on the prevalence of physical and psychosocial consequences of prolonged obstructed labour. Our study suggests that the burden of disease resulting from prolonged obstructed labour is currently underestimated. Notably, women who suffer from prolonged obstructed labour have a high prevalence of psychosocial sequelae but these are often not included in burden of disease estimates. In addition to preventative and public health measures, high quality surgical and anaesthesia care are urgently needed to prevent prolonged obstructed labour and its sequelae

Cross-sectional study · Disease · Genitourinary system · Obstructed labour · Physical therapy · Pregnancy · Psychiatry · Psychosocial · Appendicitis Diagnosis and Management · Demography · Medicine · Pelvic floor disorders treatments · Ureteral procedures and complications · Epidemiology · Internal Medicine · Pediatrics

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