SEPTIC/UNSAFE ABORTION: A PREVENTABLE TRAGEDY
AbstractBackground: Unsafe abortion is one of the greatest neglected problems of health care in developingcountries like Pakistan. In countries where abortions are restricted women have to resort toclandestine interventions to have an unwanted pregnancy terminated. The study was conducted tofind out the prevalence of septic induced abortion and the associated morbidity and mortality and tohighlight the measures to reduce it. Methods: This cross-sectional descriptive study was carried outin Obs/Gyn B Unit, Ayub Teaching Hospital, Abbottabad from January 2007 to December 2011.During this period all the patients presenting with pyrexia lower abdominal pain, vaginal bleeding,acute abdomen, septic or hypovolaemic shock after undergoing some sort of intervention forabortion outside the hospital were included. After thorough history, examination and detailedinvestigations including high vaginal and endocervical swabs for culture and sensitivity and pelvicultrasound supportive management was given followed by antibiotics, surgical evacuation of uterus/major laparotomy in collaboration with surgeon as required. Patients with DIC or multiple systeminvolvement were managed in High Dependency Unit (HDU) by multidisciplinary team. Results:During the study period out of a total 6,906 admissions 968 presented with spontaneous abortion.There were 110 cases (11.36%) of unsafe abortion, 56.4% presented with vaginal discharge, 34.5%with vaginal bleeding, 21.8% with acute abdomen, while 18.9% in shock and 6.8% with DIC. Fortynine percent patients used termination as a method of contraception. Mortality rate was 16.36%,leading cause being septicaemia. Conclusion: Death and severe morbidity from unsafe abortions andits complications is avoidable through health education, effective contraception, early informedrecognition and management of the problem once it occurs.Keywords: Abortion, unsafe, septic, DIC, Prevention
Saultes TA, Devita D, Heiner JD. The back alley revisited:
sepsis after attempted self-induced abortion. West J Emerg
Pazol K, Gamble SB, Parker WY, Cook DA, Zane SB,
Hamdan S. Abortion surveillance —United States,
MMWR Surveill Summ 2009;58(8):1–35.
McKenna T, O'Brien K. Case report: group B streptococcal
bacteremia and sacroiliitis after mid-trimester dilation and
evacuation. J Perinatol 2009;29(9):643–5.
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(1):3–8.
Hakim-Elahi E, Tovell HM, Burnhill MS. Complications of
first-trimester abortion: a report of 170,000 cases. Obstet
Stuart GS, Sheffield JS, Hill JB, McIntire DD, McElwee B,
Wendel GD. Morbidity that is associated with curettage for
the management of spontaneous and induced abortion in
women who are infected with HIV. Am J Obstet Gynecol
Stubblefield PG. First and second trimester abortion. In:
Nichols DH, (Ed). Gynecologic and Obstetric Surgery.
Mosby-Year Book; 1993.p. 1016–30.
Stubblefield PG. Pregnancy termination. In: Obstetrics:
Normal and Problem Pregnancies. 3rd ed. New York:
Churchill Livingstone; 1996:1249–76.
Stubblefield PG, Grimes DA. Septic abortion. N Engl J Med
Osazuwa H, Aziken M. Septic abortion: a review of social
and demographic characteristics. Arch Gynecol Obstet
Lohr PA. Surgical abortion in the second trimester. Reprod
Health Matters 2008;16(31 Suppl):151–61.
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.