creators_name: Bhattacharya, S creators_name: Mukherjee, G creators_name: Mistri, P creators_name: Pati , S creators_id: shritanub@gmail.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2010-09-13 03:52:06 lastmod: 2011-03-11 08:57:44 metadata_visibility: show title: Safe abortion – Still a neglected scenario: A study of septic abortions in a tertiary hospital of Rural India ispublished: pub subjects: OJHAS full_text_status: public keywords: Unsafe abortion, maternal mortality, India abstract: Background and Aims: In spite abortion has been legalized in India over three decades, unsafe abortion continues to be a significant contributor of maternal mortality and morbidity. The aim of the present study is to assess the magnitude of septic abortion in a tertiary care hospital over a period of three years with a special emphasis on maternal mortality and morbidity and various surgical complications. Settings and Design: Retrospective study of patients who were admitted with unsafe abortions over a three year period from 2005 to 2008 in a tertiary teaching Hospital of Rural India. Materials and Methods: Hospital records of the patients who were admitted with unsafe abortion in three years (2005-2008) were reviewed to evaluate the demographic and clinical profile in relation to age, parity, marital status, indication of abortion , the methods of abortion ,qualification of abortion provider complications and maternal mortality. Results: Unsafe abortion constitutes 11.6% ( n=132) of total abortion cases admitted over 3 years. Majority of women (70.45%) were in their thirties, married (89%).Sixty percent wanted abortion for birth spacing. Abortion methods included various primitive methods (30%) but majority by dilatation and evacuation. About 60% of abortionists were unqualified. Majority of women admitted with serious complications like peritonitis (70%), visceral injuries (60%), hemorrhagic and septic shock, renal failure (17.4%), and life threatening conditions like DIC, hepatic failure and encephalopathy. A total of 231 women died of unsafe abortion making it 12.55% of total maternal mortality in our institution. Out of 73 women requiring laparotomy, 22% were done within 24 hours of admission and majority (49%) were performed beyond 24-48 hours. Interestingly no women died when early aggressive surgery was done. Conclusion: The present study confirms that unsafe abortion is a great neglected health care problem leading to a considerable loss of maternal lives. Education and accessibility of contra caption, readily available, quality abortion services by trained abortion providers remain the key to limit mortality and morbidity arising from unsafe abortion. date: 2010-07-30 date_type: published publication: Online Journal of Health and Allied Sciences volume: 9 number: 2 publisher: Dr. B.S. Kakkilaya refereed: TRUE referencetext: 1. Dixon-Mueller R. Abortion policy and women’s health in developing countries. Int J Health serv 1990;20(2):297–314. 2. World Health Organisation. Abortion: A tabulation of Available Data on the frequency and Mortality of Unsafe abortion, 2nd edn. World Health Organisation, Geneva. 1994. 3. Meenakshi, Sirohiwal D, Sharma D. A review of septic abortion. J Obstet Gynecol Ind 1995;45(2):186–90 4. Guin G, Gupta A, Khare S, Chandra M, Kalkar S. A study of septic abortions: trends in a tertiary hospital. J Obstet Gynecol Ind. 2005;55(3):257-260. 5. Jain V, Saha SC, Bagga R, Gopalan S. Unsafe abortion: A neglected tragedy. Review from a tertiary care hospital in India. J. Obstet. Gynaecol. 2004;30(3):197-201. 6. World Health Organisation. Medical methods for termination of pregnancy. Report of a WHO Scientific group. World Health Organ Tech Rep series 1997; 871: I –VII. pp. 1-110. 7. Office of Population Censuses and Surveys. British Statistics. London: The Stationary Office, 1994. 8. Sood M, Juneja Y, Goyal U.Maternal mortality and morbidity associated with clandestine abortions. Journal of the Indian Medical Association,1995;93(2): 77 – 9. 9. Naib JM, Siddiqui MI, Afridi B. A review of septic induced abortion cases in one year at Khyber teaching hospital, Peshwar. J Ayub Med Coll Abbottabad. 2004;16(3):59-62. 10. Konze JC, ObisesanKA, Ladipo A. Health and economic consequences of septic induced abortion. Int J Gynaecol Obstet. 1992;37:193-7. 11. Agrawal A, Salhan S. Septic abortion – Current scenario in a tertiary care hospital. J Obstet Gynecol Ind 2008;58(2):147-51. 12. Sule-odu AO, Olatunji AO, Akindele RA. Complicated induced abortion in Sagamu, Nigeria. J Obstet Gynaecol 2002;22:58-61 13. Darney PD. Training physicians in elective abortion techniques in United States. In Landy U, Ratnam SS ( eds) Prevention and treatment of contraceptive failure. New York. Plenum Press. 1986. pp 133-40 14. Fried G, Ostlun E, Ullberg C, Bygdeman M. Somatic Complications and contraceptive techniques following legal abortion. Acta Obstet gynecol Scand 1989;68(6):515–21. 15. Rana A, Pradhan N, Gurung G, Singh M. Induced septic abortion: A major factor in maternal mortality and morbidity. Journal of Obstetrics and Gynaecology Research. 2004;30(1):3-8. 16. Lapido OA. Preventing and managing complications of induced abortions in third world countries. Int J Gynecol Obstet 1989;30:21-8 17. Fawole AA, Aboveii AP. Complications from Unsafe abortion: Presentations at Iorin, Nigeria. Niger J Med. 2002:11(2):77-80. 18. Meqafu U. Bowel injury at septic abortion: The need for more aggressive management. Int J Gynecol Obstet 1980;17(5):450-453 citation: Bhattacharya, S and Mukherjee, G and Mistri, P and Pati , S (2010) Safe abortion – Still a neglected scenario: A study of septic abortions in a tertiary hospital of Rural India. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/7006/1/2010-2-7.pdf