MATERNAL MORBIDITY AND MORTALITY;

ASSOCIATION WITH UNSAFE ABORTION

Abstract

Objective: To assess the demographic features of unsafe abortion and associated maternal morbidity and mortality, and
availability of post abortion care. Study Design: A Case-Series. Place and Duration of Study: The study was carried out in Gynae Unit-1 of
Bahawal Victoria Hospital (BVH), Bahawalpur from 1st January 2009 to 31st December 2009. Material and Methods: Patients admitted with
complicated unsafe abortion were evaluated regarding age, parity, marital status, educational status, socio-economic status, indication of
abortion, qualification of abortionist and method used for abortion, contraceptive usage, immediate complications and death rate in abortion
seekers. Descriptive statistics were used for describing variable. Results: 119 patients were admitted with unsafe abortion. The mean age was
28.5 years. 90.8% women were married, 59.6% multiparous, 21% got secondary and higher education, 62 belonged to poor socio-economic
status. In 72% cases unsafe abortion was done during 1st trimester and 80% of women had previous history of unsafe abortion, 95%
approached unqualified / semi skilled abortion providers who used instrumentation in 53% cases. The most common reason for abortion was
multiparity (48%),& poor socio-economic status (19%), only 26.5% were using some kind of contraception. Most common complications were
continued ongoing haemorrhage (incomplete abortion in 44%), followed by septic complications in 25% of cases and trauma to urogenital tract
(22%) which also involved gut in 6% of cases. 2.5% patients reached in very critical stage & could not survived. Post abortion care provided to
all patients of which 22% managed conservatively & 78% managed surgically. Contraception services offered to all but 24% refused them
totally. Conclusions: Unsafe abortion constitutes a major threat to health and lives of women. Most of them are multiparous, married at peak of
their reproductive life and belong to poor economic status. The associated immediate morbidity is much higher than mortality in terms of
continued haemorrhage, sepsis, and trauma. The study focused on the need of post abortion care and easy accessibility to contraception to
improve quality of life.