Medical Interruption of Pregnancy in the Second Trimester at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF): About 25 Cases

摘要

Introduction: Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. Objective: To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). Methodology: This was a retrospective and descriptive study conducted at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, i.e. a period of 9 years. All patients who underwent a medical termination of pregnancy during the study period and whose term of pregnancy was <28 weeks of amenorrhea were included in this study. Information was collected on a survey sheet from the patients’ clinical records, admission and hospitalisation registers, referral forms and operative report registers. Data were entered and analyzed using Excel, World and epi-info 7.2.2. The main variables studied were hospital frequency, diagnostic means, main indications, means of evacuation and maternal prognosis. Result: 25 patients were identified and represented 0.5% of deliveries. Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical ultrasound was performed in 100% of patients. These ultrasounds allowed us to determine fetal vitality and to find some fetal malformations (28%) and some anomalies in the fetal appendages (48%). Clinical examination alone was used to diagnose 24% of indications. In 68% of cases, the clinical examination and ultrasound were used to establish the indication. The most commonly used evacuation technique was medication in 88% of cases. Caesarean section was chosen for urgent cases in 12%. Uterine haemorrhage and post-abortion endometritis were the main complications. Conclusion: Medical termination of pregnancy is a delicate subject requiring multidisciplinary management. This series has allowed us to highlight our singularities, and will allow us to improve the management of our patients, in the prevention of haemorrhage and other complications.