A clinical study of septic abortions in a tertiary care referral centre in rural India - Still a neglected scenario which can be a preventable catastrophe

Abstract

Objectives:The aim of the present study was to assess the magnitude of septic abortion in a tertiary care referral hospital and study their complications. Methods: It was a retrospective study done on patients who were admitted from January 2008 to December 2012 in our hospital. Hundred thirty two (132) patients were included in the study. The demographic and clinical profile in relation to age, parity, marital status, indication of abortion, the methods of abortion used, qualification of health care provider, complications and maternal mortality were evaluated. Results: Unsafe abortion constitutes 11.6% of total abortion cases. Ninety three (70.45%) women were in their third decade, 89% were married and 60% had abortion for birth spacing. In 30% of cases primitive methods were used, but majority of them were terminated by dilatation and evacuation method. Eighty three (62.9%) of abortions were done by unqualified persons. Majority of women were admitted with serious complications like peritonitis (70%), visceral injuries (60%), hemorrhagic and septic shock, renal failure (17.4%), and other conditions like DIC, hepatic failure and encephalopathy. Out of 73 women requiring laparotomy, 22% were done within 24 hours of admission and 49% were performed beyond 24-48 hours. Conclusion:The present study confirms that education and accessibility of contraception, readily available, quality abortion services by trained health providers can limit morbidity and mortality arising from unsafe abortion.Keywords: Unsafe abortion, maternal mortality, rural India.Although abortion has been legalized in India from 1972, unsafe abortion still continues to be a major contributor of maternal morbidity and mortality. Termination of pregnancy, although a safe procedure in trained hands, can produce disastrous outcomes when performed by untrained and unauthorized people in rural settings. Nearly thirteen percent of all illegal abortions in the world are carried out in India 1 . Out of 20 million women who undergo unsafe abortion annually, 70,000 die while millions suffer chronic morbidities 2 . The aim of the study was to evaluate cases of septic abortions admitted to a tertiary care hospital over a period of five years in relation to the magnitude of unsafe abortion and also to assess various epidemiological factors like age, gravida, RESEARCH ARTICLEReceived: 4 th November 2017. Accepted: 10 th December 2017. Vijayasree M. A clinical study of septic abortions in a tertiary care referral centre in rural India -Still a neglected scenario which can be a preventable catastrophe. The New Indian Journal of OBGYN. 2018; 4(2): 121-25.