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Septic abortion at a university teaching hospital in South West Nigeria.
Abstract
Background: Abortion is a common cause of maternal mortality and this usually follows severe haemorrhage or sepsis. Septic abortion is sequelae of unsafe abortion and this usually occurs when it is done in a clandestine manner which may be due to lack of legalization of abortion. The study is to determine the pattern of septic abortion managed in the hospital. METHOD:
This is a retrospective study of consecutive cases of septic abortion that were admitted into the gynaecological ward between 1998 and 2007 in the hospital. The diagnosis of sepsis was based on clinical and laboratory findings. RESULTS: Thirty-four cases of septic abortion that warranted admissions were seen during the study period and this represented 1.64% of all gynaecology ward admissions. The age range of the patients was between 15-41years with a mean of 24.53years and nulliparous patients represented 47.1%. Fifty eight percent of the abortions were done by quacks while 9.7% was done by medical doctors. The abortion was induced in 91.2% of the cases and only 20.6% of the patients had not had a previous abortion. The abortion was by dilatation and curettage in 61.8% of the cases. The gestational age at abortion ranged between 5 and 26 weeks with majority at 6-10weeks (47.1%) with a mode of 8weeks. Apart from the sepsis, 61.8% of the patients had other complications like anaemia and peritonitis. Definitive management was by conservative measures in 79.4 % with antibiotics and evacuation. The mean interval between abortion and presentation at OOUTH was 9.9days. There was only one case of mortality in the series giving a case fatality rate as 2.94%. Conclusion There is a need for training and retraining of health workers on methods of evacuation of the uterus and early detection of complications. Since it is a problem that is more common among nulliparous young adults, more effort
need to be made to reach out to the young adult through incorporation of family life education.
This is a retrospective study of consecutive cases of septic abortion that were admitted into the gynaecological ward between 1998 and 2007 in the hospital. The diagnosis of sepsis was based on clinical and laboratory findings. RESULTS: Thirty-four cases of septic abortion that warranted admissions were seen during the study period and this represented 1.64% of all gynaecology ward admissions. The age range of the patients was between 15-41years with a mean of 24.53years and nulliparous patients represented 47.1%. Fifty eight percent of the abortions were done by quacks while 9.7% was done by medical doctors. The abortion was induced in 91.2% of the cases and only 20.6% of the patients had not had a previous abortion. The abortion was by dilatation and curettage in 61.8% of the cases. The gestational age at abortion ranged between 5 and 26 weeks with majority at 6-10weeks (47.1%) with a mode of 8weeks. Apart from the sepsis, 61.8% of the patients had other complications like anaemia and peritonitis. Definitive management was by conservative measures in 79.4 % with antibiotics and evacuation. The mean interval between abortion and presentation at OOUTH was 9.9days. There was only one case of mortality in the series giving a case fatality rate as 2.94%. Conclusion There is a need for training and retraining of health workers on methods of evacuation of the uterus and early detection of complications. Since it is a problem that is more common among nulliparous young adults, more effort
need to be made to reach out to the young adult through incorporation of family life education.
