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SEPTIC/UNSAFE ABORTION: A PREVENTABLE TRAGEDY

机译:癫痫/不安全堕胎:可预防的悲剧

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Background: Unsafe abortion is one of the greatest neglected problems of health care in developing countries like Pakistan. In countries where abortions are restricted women have to resort to clandestine interventions to have an unwanted pregnancy terminated. The study was conducted to find out the prevalence of septic induced abortion and the associated morbidity and mortality and to highlight the measures to reduce it. Methods: This cross-sectional descriptive study was carried out in Obs/Gyn B Unit, Ayub Teaching Hospital, Abbottabad from January 2007 to December 2011. During this period all the patients presenting with pyrexia lower abdominal pain, vaginal bleeding, acute abdomen, septic or hypovolaemic shock after undergoing some sort of intervention for abortion outside the hospital were included. After thorough history, examination and detailed investigations including high vaginal and endocervical swabs for culture and sensitivity and pelvic ultrasound supportive management was given followed by antibiotics, surgical evacuation of uterus/ major laparotomy in collaboration with surgeon as required. Patients with DIC or multiple system involvement were managed in High Dependency Unit (HDU) by multidisciplinary team. Results: During the study period out of a total 6,906 admissions 968 presented with spontaneous abortion. There were 110 cases (11.36%) of unsafe abortion, 56.4% presented with vaginal discharge, 34.5% with vaginal bleeding, 21.8% with acute abdomen, while 18.9% in shock and 6.8% with DIC. Fortynine percent patients used termination as a method of contraception. Mortality rate was 16.36%, leading cause being septicaemia. Conclusion: Death and severe morbidity from unsafe abortions and its complications is avoidable through health education, effective contraception, early informed recognition and management of the problem once it occurs. Keywords: Abortion, unsafe, septic, DIC, Prevention
机译:背景:不安全堕胎是巴基斯坦等发展中国家中医疗保健中最被忽视的问题之一。在人工流产受到限制的国家,妇女必须诉诸秘密干预措施才能终止意外怀孕。进行该研究以发现败血性流产的患病率以及相关的发病率和死亡率,并着重指出减少流产的措施。方法:该横断面描述性研究于2007年1月至2011年12月在阿伯塔巴德阿尤布教学医院的Obs / Gyn B单位进行。在此期间,所有患者均表现为发热性下腹痛,阴道出血,急性腹部,败血病或在医院外接受某种形式的人工流产后出现血容量不足的休克。经过彻底的病史检查和详细检查,包括高阴道和宫颈内拭子的培养和敏感性,以及盆腔超声支持管理,然后进行抗生素治疗,必要时与医生合作进行子宫/大剖腹手术。 DIC或多系统参与的患者由多学科团队在高依赖性病房(HDU)中进行管理。结果:在研究期内,共有6906例自发流产的968例患者。不安全流产的病例为110例(11.36%),有白带的占56.4%,阴道流血的占34.5%,急腹症的占21.8%,休克的有18.9%,DIC的有6.8%。占100%的Fortynine患者使用终止疗法作为避孕方法。死亡率为16.36%,导致败血症。结论:通过健康教育,有效的避孕措施,对问题的尽早知情识别和处理,可以避免因不安全流产及其并发症而导致的死亡和严重发病。关键字:流产,不安全,化脓,DIC,预防

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