METHODS AND COMPLICATIONS OF SEPTIC INDUCED ABORTION IN PATIENTS MANAGED AT A TERTIARY CARE HOSPITAL
AbstractBackground: To study the methods used for the termination of pregnancy and associated complications of induced abortion. Methods: This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol. Data was collected on a specially designed Performa. Patients were interviewed in privacy and factors contributing to termination of pregnancy like age, parity, socioeconomic status and contraceptive failure were determined. Methods used for the procedure, status of abortionist were asked. Complications were determined by history, clinical examination and ultrasound examination. In view of all above data recommendations of preventing unwanted pregnancies were made. Results: All patients were married and 57% of women belonged to age group of 31–40 years. Fifty-four 54% were grand multipara. In 63% of patients, induced abortion was carried out by Dai’s. Most commonly used method was instrumentation (72%). Financial problems (46.7%) and high parity (40%) were the most common factors contributing to termination of pregnancy. Serious complications like uterine perforation with or without bowel injury were accounted in 13% of women, septicaemia in 61%, peritonitis in 15% and DIC in 2%. During the study period illegally induced abortion accounted for 2% maternal deaths. Conclusion: Prevalence of poverty, illiteracy, grand multiparity and non-compliance of contraception were strong determinants of induced abortion, instrumentation being the most commonly used procedure resulting in high morbidity and mortality.Keywords: Abortion, complications, Induced abortion, Morbidity, mortality, Uterine perforation, Septicaemia, DIC
Rana A, Pradhan N, Gurung G, Singh M. Induced septic abortion: a major factor in maternal mortality and morbidity. J Obstet Gynaecol Res 2004;30:3–8.
Stedman TL. Stedman’s medical dictionary. 21st ed. Baltimore: Williams and Williams: 1966; 4.
Fikree F. Reproductive health in Pakistan: evidence and future directions. J Pak Med Assoc 2002;52:34–41.
Devereux G. A Typological Study of Abortion in 350 Primitive, Ancient and Pre-Industrial Societies. In: Rosen H. (Ed). Therapeutic Abortion. New York: Julian Press Inc; 1954.
David HP. Abortion Policies. In: Hodgson JE. (Ed). Abortion and Sterilization: Medical and Social Aspects. New York: Grune and Stratton; 1981.p. 1–40.
Thapa S, Padhye SM. Induced abortion in urban Nepal. Int Fam Plann Perspect 2001;27(3)144–7.
Phillip G, Field S, Grimes DA. Septic abortion. N Eng J Med 1994;331:310–4.
Korejo R, Noorani KJ, Bhutta S. Sociocultural determinants of induced abortion. J Coll Physicians Surg Pak 2003;13:260–2.
Khin Kye M. Maternal mortality at South Okkalapa. Aust NZJ Obstet Gynecol 1988;28:36–40.
Sadik N. The State of World Population 1997. New York: UNFPA; 1997. Available at: http://www.unfpa.org/swp/ 1997/notes.htm
Family Care International. Sexual and Reproductive Health Briefing Cards. New York: Family Care International; 1999.
Abortion: A tabulation of available information. Safe Motherhood IAG, Unwanted Pregnancy. 3rd ed. Geneva: WHO; 1997.
Jain V, Saha SC, Bagga R, Gopalan S. Unsafe abortion: A neglected tragedy. Review from a tertiary care hospital in India. J Obstet Gynaecol 2004;30(3):197–201.
McFarlane DR. Induced Abortion: An historical overview. Am J Gynaecol Health 1993;7(3):77–82.
Hurst J. The history of abortion in the Catholic Church: The untold story. Washington DC: Catholics for a Free Choice; 1983. p. 2222.
McLellan AA. Abortion Law in Canada. In: Butler JD, Walbert DF (Eds). Abortion, Medicine and the Law. Martinsville: Fideli Publishing Inc; p.334.
Henshaw SK. Recent trends in the legal status of induced abortion. J Public Health Policy 1994:165–72.
Boland R. Selected legal developments in reproductive health in 1991. Fam Plann Perspectives 1992;24(4):178–85.
Al-Hibri AY. Family Planning and Islamic Jurisprudence, IN/FIRE Ethics, Newsletter of the International Network of Feminists Interested in Reproductive Health. Trust 1994:3(2):42.
Sadik N. The State of World Population 1997. New York: UNFPA; 1997.
Segal SJ, LaGuardia KD. Termination of pregnancy –a global view. Baillière’s Clin Obstet Gynaecol 1990;4(2):235–47.
Expanding access to safe abortion: Key Policy Issues. Washington DC: Population Action International; 1993.
Kinoti SN. Gaffikin L, Benson J, Nicholson LA. Monograph on Complications of Unsafe Abortion in Africa. Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa, Arusha, Tanzania: 1995. Available from: http://pdf.usaid.gov/pdf_docs/PNACB975.pdf
Heise L, Moore K, Toubia N. Sexual coercion and reproductive health: A focus on research. New York: Population Council; 1995.
Gaufberg SV. Abortion, septic. [online] September 28, 2004. Available from: http/www.e-medicine.com. [cited 26 June 2005]
WHO- The prevention and management of unsafe abortions. Geneva. WHO/msm/1992;5. Available from: http://whqlibdoc.who.int/hq/1992/WHO_MSM_92.5.pdf
van der Klis KA, Westenberg L, Chan A, Dekker G, Keane RJ. Teenage pregnancy: trends characteristics and outcomes in South Australia and Australia. Aust NZJ Public health 2002;26:125–31.
Stuart MA, van der Wal MF, Schilthuis W. Births and abortions among Amsterdam teenages according to ethinicity,1996–1998. Ned Tijdschr Geneekd 2002;146:263–7.
Naib JM, Siddiqu MI, Afridi B. A review of septic induced abortion cases in one year at Khyber Teaching Hospital, Peshawar. J Ayub Med Coll Abbottabad 2004;16(3):59–62.
Naz F, Begum A. Septic induced abortion, the prevalence, logics and complications. Biomedica 2004;20(2):110–3.
Hussain M, Ashraf M, Noorani K. Alleged reasons and complications of induced abortion. J Surg Pak 2004;9(3):18–21.
Bhutta SZ, Aziz S, Korejo R. Surgical complications following unsafe abortion. J Pak Med Assoc 2003;53(7):286–9.
Gebreselassie H, Gallo MF, Monyo A, Johnson RB. The magnitude of abortion in Kenya. Br J Obstet Gynaecol 2004;111:1–7.
Jones EF, Forrest JD. Under reporting of abortions in surveys of USA women. Demography 1992;29:113–6.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.