چکیده
Background: Induced abortion is common and largely performed under clandestine and unsafe conditions in Nigeria. Complications from such procedures contribute significantly to maternal morbidity and mortality in the country.
Objective: To determine the sociodemographic characteristics and pattern of complications present in patients managed for unsafe abortion.
Setting: The patients studied were treated in Federal Medical Centre, Ido Ekiti, a tertiary health institution located in a rural town and a main referral hospital in Ekiti State, South West Nigeria.
Methodology: The records of patients admitted for complications of unsafe abortion over a 5-year period were analyzed with regard to sociodemographic characteristics, gestational age at termination of pregnancy, the providers, methods used and the complications they develop.
Results: A total of 102 patients were treated for complications of unsafe abortion during the period under review constituting 7.4% of total gynaecological admission. Majority (60.4%) of the patients were less than 25 years old, 74.0% were students while 81.3% were unmarried. Only 9.4% of the women had ever used contraceptives. Of all the cases, 21 (21.9%) were performed within 8 weeks of gestation while 47.9% were performed in the second trimester. Surgical uterine evacuation was the method used in 67.7% of the patients and 65.6% ofthe abortions were performed by non physicians. Sepsis was the commonest complication in the patients (79.2%) while uterine perforation was present in 12.5% of the women. The case fatality rate was 16.6% and unsafe abortion accounted for 30.8% of all maternal mortality during the period.
Conclusion: As young single nulliparous students are the principal sufferers of complications of unsafe abortion in this study, young persons,
especially in-school adolescents, should be targeted for the provision of comprehensive reproductive health services.
Keywords: Unsafe abortion, complications
Résumé
Introduction: L’avortement induit est commun et en grande partie exécuté dans des conditions clandestines et à risque au Nigéria. Les complications de telles procédures contribuent de manière significative à la morbidité et mortalité maternelles dans le pays. L’objectif de cette étude était de déterminer les caractéristiques et la fréquence sociodémographique des complications récentes chez les patients contrôlés pour l’avortement à risque.
Méthodologie: Les patients étudiés ont été soignés au centre médical fédéral, Ido Ekiti, une institution de santé tertiaire située dans une ville rurale et un hôpital principal de référence dans l’Etat d’Ekiti, au sud du Nigéria. Les registres des patients admis pour des complications d’avortement à risque sur une période de cinq ans ont été analysés en ce qui concerne des caractéristiques sociodémographiques, l’âge gestationnel à l’arrêt de la grossesse, les fournisseurs, des méthodes employées et les complications qu’ils développent.
Résultats : Un total de 102 patients a été soigné pour des complications d’avortement à risque au cours de la période à l’étude constituant 7,4% de l’admission gynécologique totale. La majorité (60,4%) des patients avait moins de 25 ans, 74,0% étaient des étudiants tandis que 81,3% étaient célibataires. Seulement 9,4% des femmes n’avaient jamais employé des contraceptifs. De tous les cas, 21 (21,9%) ont été exécutés dans un délai de 8 semaines de gestation tandis que 47,9% étaient exécutés dans le deuxième trimestre. L’évacuation utérine chirurgicale était la méthode employée chez 67,7% des patients et 65,6% des avortements ont été exécutés par des non-médecins. La septicémie était la complication la plus commune chez les patients (79,2%) tandis que la perforation utérine était présente chez 12,5% des femmes. Le taux des dégâts des cas était 16,6% et l’avortement à risque a expliqué 30,8% de toute la mortalité maternelle au cours de la période.
Conclusion: les jeunes étudiantes nullipares célibataires sont les principales victimes des complications de
l’avortement à risque dans cette étude, des jeunes particulièrement adolescents internés, devraient être visés pour la
prestation des services complets d’éducation en santé reproductive et anténatale.
Correspondence: Dr. Omoniyi Moses Abiodun, Department of Obstetrics and Gynaecology, College of Health Sciences, Osun State University, Osogbo, Nigeria.
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