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Complications and Management of Unsafe Abortion

机译:不安全堕胎的并发症和处理

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Abstract Objective: To determine the frequency of unsafe abo-rtion and its morbidity and mortality in patients pre-senting at Lady Aitchison Hospital Lahore (KEMU Lahore). Study Design: Descriptive study. Place and Duration of study: Department of Obs-tetrics and Gynecology, Lady Aitchison Hospital La-hore, from 1st January 2006 to 31st December 2010. Patients and Methods: All patients with history of induced abortion were admitted. The particulars rela-ted to each case like age, marital status, parity, reason for requesting abortion, place and expertise of person carrying out the procedure and outcome were recor-ded. Once patient arrived in our unit detailed examina-tion was done and relevant investigations sent. After primary resuscitation and optimization, the patients were managed according to their complications in col-laboration with general surgical department. Results: 120 mostly young ladies with age range of 17 to 47 years and mean age of 30.76 years, presented with complications of induced abortion. 110 patients were married and 10 were single mothers. 30 patients (25%) were nullipara and remaining 90 (75%) were having 5 or more children. Only 14 out of 120 patients?were booked cases, who underwent elective therape-utic medical termination of pregnancy (for foetal con-genital anomalies in 10 cases and maternal grade III cardiac disease in 4 cases) They had no complication. 106 patients presented with induced and unsafe abor-tion. They were referred cases, and had multiple com-plications. 4 patients were brought dead and two pati-ents died during pre-operative resuscitation. 3 patient died post operative due to septicemia. Out of remain-ing 100 patients, 12 (10%) were managed conserva-tively, 50 (50%) had re-evacuation and 38 (38%) underwent exploratory laparotomy. Ileal perforation was found in 11 cases. These were treated by primary repair and resection and anastomosis (4 cases each) and ileostomy in 3 cases. Sigmoid perforation was found in 5 cases and managed by distal end colostomy. Repair of uterine perforation only was done in 11 cases. Hysterectomy was performed in 11 patients. In 34 patients peritoneal toilet was also done. Overall mortality was 9.6% (10). Conclusions: Our study shows high morbidity and mortality associated with induced unsafe abortion in the form of prolonged hospital stay, multiple blood transfusions, laparotomies, hysterectomies that com-promises the future fertility of young patients.
机译:摘要目的:确定在拉合尔夫人艾奇森医院(KEMU Lahore)宣誓就诊的患者中不安全堕胎的频率及其发病率和死亡率。研究设计:描述性研究。研究的地点和时间:2006年1月1日至2010年12月31日,位于拉迪尔爱迪生夫人医院妇产科。患者和方法:纳入所有有人工流产史的患者。记录了与每个病例有关的细节,例如年龄,婚姻状况,均等,要求堕胎的原因,进行手术的人的位置和专业知识以及结果。一旦患者到达我们单位,便会进行详细检查并发送相关调查。经过初步的复苏和优化后,根据患者的并发症与普通外科一起进行管理。结果:120名多数为年轻女性,年龄在17至47岁之间,平均年龄为30.76岁,表现为人工流产并发症。已婚110例,单身母亲10例。 30名患者(25%)为无原位,其余90名(75%)有5个或更多的孩子。在120例患者中,只有14例接受了择期终止妊娠的治疗(因胎儿先天性异常10例,母亲III级心脏病4例),他们没有并发症。 106例出现人工流产和不安全流产。他们是转诊病例,并有多种并发症。术前复苏中有4例患者死亡,两名患者死亡。 3例患者术后因败血症死亡。其余100例患者中,保守治疗12例(10%),再次疏散50例(50%),进行探索性剖腹手术38例(38%)。发现11例回肠穿孔。这些患者均接受了初步修复和切除和吻合术(每例4例)和回肠造口术3例。乙状结肠穿孔5例,并通过远端结肠造口术处理。仅11例修复了子宫穿孔。子宫切除术进行了11例患者。在34名患者中,还进行了腹膜洗手。总死亡率为9.6%(10)。结论:我们的研究表明,长期住院,多次输血,开腹手术,子宫切除术等与不安全流产有关的高发病率和死亡率,这些都有助于年轻患者的未来生育能力。

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