The Outcome of Septic Abortion: A Tertiary Care Hospital Experience

Abstract

Objective To study the incidence of septic abortion, reasons for that, sociodemographic profile, abortion providers, complications faced, and treatment given and its outcome. Methods All the women with septic abortion admitted at Government Maternity Hospital, Tirupathi, over a period of 2 years 4 months duration from July 2007 to October 2009 were studied prospectively. Observations and results Incidence of septic abortion in our study was 6.78 %. 72 % of cases were performed by qualified medical personnel. Fourteen patients had complications, among them peritonitis, pelvic abscess, renal failure, and septic shock were common. Twenty-six patients had Grade-I sepsis, Grade-II: 8, Grade-III: 4, and Grade-IV: 4. Laparotomy was done in six cases. There was no mortality in our study. Conclusion The tragedy of septic-induced abortion is totally preventable. It only needs definitive commitment to women's health by providing effective contraception, strengthening the family welfare services, and discouraging repeated terminations of pregnancy as contraceptive method.

Evaluation of Factors Related to Labour in Women with Puerperal Sepsis

“…Grade I -infection localized to the uterus, Grade II -infection spreading to pelvis and abdomen without signs of generalized sepsis, grade III -septicemia with clinical evidence of infection -fever, hypothermia, tachycardia, tachypnea and evidence of inadequate organ perfusion. Grade IV -patients with septic shock [11]. Mean ± SD = 34.78 ± 4.82 wks…”

Vulnerability in adolescence: a case report of attempted abortion and sexual violence

“…About half of women who had abortions received care in the health system and were hospitalized for complications 16,17 . Considered a persistent and preventable pandemic world wide 6,15,16 , unsafe abortion 17 places women at risk in developing countries where abortion is highly restricted by law or, although legally permitted as in Brazil in cases of pregnancy resulting from rape, when there is no other means of saving the life of the mother 18 , safe abortion is not easily accessible 6 . In such settings, faced with an unwanted pregnancy, women often induce abortion or obtain clandestine abortions from doctors, paramedics, or traditional healers 1 .…”

“…However, social vulnerability is present in this context, where economic and educational levels interfere with access to safe and law ful abortion 18,[30][31][32] . The incidence of septic abortion varies widely among developing and developed countries 6,7 and is also related to adolescence 7,20 . Serious infections resulted from unsafe abortion practices with consequent sepsis 3,4,6,7,9 or severe hemorrhages 3 may have a definitive repercussion on reproductive life, such as hysterectomy 3,4,6 and sepsis in cases of foreign body insertion 3,13 .…”

“…In Brazilian public health, this has a negative effect on the economy, which can vary up to 2% of GDP (gross domestic product) 2 , as well as maternal consequences related to the morbidity and mortality of our women [3][4][5] . Unsafe abortion appears as an alternative to unwanted pregnancies 1,6,7 , mainly in cases related to physical violence, sexual violence, usually caused by an intimate or known partner. In such cases, abortion would be provided by law in some countries 3,6 , but patients who suffer violence do not report or hide for various vulnerabilities -age, social and institutional [8][9][10] .…”

“…Unsafe abortion appears as an alternative to unwanted pregnancies 1,6,7 , mainly in cases related to physical violence, sexual violence, usually caused by an intimate or known partner. In such cases, abortion would be provided by law in some countries 3,6 , but patients who suffer violence do not report or hide for various vulnerabilities -age, social and institutional [8][9][10] . Sexual abuse 11 during adolescence is a traumatic experience that complicates young women's psycho-social development at the threshold of adulthood 2 , resulting in consequences associated with sexually transmitted diseases, pregnancy followed by violence, unwanted pregnancies, psychosocial repercussions 7 and negative sequel e that compromise reproductive health and sexual 1 .…”