ASSOCIATION OF UNSAFE ABORTIONS WITH COMPLICATONS

Abstract

Background; Unsafe abortion is a persistent, preventable pandemic. WHO defines unsafe abortion as a procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both. This study was conducted in our local population of southern Punjab to ascertain magnitude of the problem in terms different maternal complications after unsafe abortions. Objective: To determine the frequency of complications of unsafe abortions at a tertiary care hospital. Material and Methods; All the study cases (n=169) who met inclusion criteria of my study were taken from Department of Gynecology and Obstetrics, Bahawal Victoria Hospital, Bahawalpur, Pakistan from June 2015 to June 2016 in this descriptive cross – sectional study . Once registered, these study case had undergone required investigations like blood tests (TLC count to determine sepsis and serum urea and creatinine levels to ascertain ARF). These blood tests were performed by a trained pathologist. These patients were also arranged for X – Ray chest (PA view) to diagnose perforation and complications such sepsis, hemorrhage, ARF and perforations were noted in the proforma by the researcher. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was 29.39 ± 4.12 years (with minimum age of our study cases was 24 years while maximum age was 37 years) and majority of our study cases i.e. 93 (55 %) belonged to age group 20 – 30 years of age. Of these 169 study cases, 104 (61.5%) were from rural areas, 113 (66.9%) were poor, 141 (83.4%) were illiterate, 111 (65.7%) spouses were illiterate and most of them i.e. 112 (66.3%) belonged to joint family system. Mean body mass index of our study cases was 24.78 ± 3.24 kg/m² and obesity was present in 27 (16 %) patients. Hemorrhage was noted in 94 (55.6%), sepsis in 74 (43.8%), acute renal failure in 39 (23.1%) and perforations in 19 (11.2%) of our study cases. Conclusion; Our study results indicate that unsafe abortion is a major cause of maternal morbidity with hemorrhage was commonest complication followed by septicemia, mostly because the procedure was performed by untrained health care providers under unhygienic conditions.  Majority of the patients had multiple complications. There is urgent need to improve quality of services offered by family planning programs and provision of safe abortion services to decrease significant morbidity among targeted population. This will improve their quality of life and also provide relief to health authorities in terms of more investments due to prolonged hospitalizations.

Keywords; Unsafe abortion, hemorrhage, sepsis.