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Training Years: 2015-2016

Training Site: UNC Project-Malawi

Country: Malawi

Mentor: Jennifer Tang , MD, MSCR; Jeff Stringer, MD

Title: Physical, psychological, and reproductive outcomes of women after obstetric fistula repair

Project Objectives: In order to implement appropriate interventions for women with obstetric fistula (OF), it is imperative to understand the long-term physical, psychosocial, economic, and reproductive health outcomes. We will address this important knowledge gap in an existing cohort of patients who have undergone OF repair in Lilongwe, Malawi.

Hypothesis: 1-hour pad weights will more accurately predict a good incontinence-related quality of life score 1-3 years after repair, compared to clinical impression of continence.

Aim 1: To evaluate whether a 1-hour pad weight or clinician impression of continence at time of hospital discharge is a better predictor of a good incontinence-related quality of life 1-3 years after OF repair.

Hypothesis: Depression at 1-3 year follow-up will be associated with pad weight at hospital discharge, current number of living children, HIV status, and current marital status.

Aim 2: To describe the prevalence of depression and evaluate the characteristics associated with depression among women 1-3 years after OF repair.

Hypothesis: Women who had abnormal anti-mullerian hormone (AMH) and/or short cervical length at the time of repair will have higher rates of infertility, miscarriage, and preterm birth when compared to women with normal AMH and cervical length.

Aim 3: To evaluate the reproductive outcomes of a subset of 100 women 1-3 years after OF repair and correlate them to their cervical length measurements and hormonal marker findings at the time of repair.

NIH Support:  Fogarty fellowship postdoctoral training award

Dawn Kopp Headshot