A clinical study of septic abortions in a tertiary care referral centre in rural India - Still a neglected scenario which can be a preventable catastrophe

Abstract

Introduction: In spite of the MTPact in 1972 which legalized abortions in India, unsafe abortion still continues to be a significant contributor of maternal morbidity and mortality. Objectives: The aim of the present study was to assess the magnitude of septic abortions in a tertiary care referral hospital and study their complications. Methods: A retrospective study of patients who were admitted from January 2010 to December 2014 in our hospital. A total of 132 patients were included in the study. The demographic and clinical profile in relation to age, parity, marital status, indication of abortion, the methods of abortion used, the qualifications of the health care provider, complications and maternal mortality were evaluated. Results: Unsafe abortion constitutes 11.6% of total abortion cases. A total of 70.45% women were in their third decade, 89% were married and 60% had abortion for birth spacing. In 30% of cases primitive methods were used, but the majority of them were terminated by D&E. Overall, 60% of abortions were done by unqualified persons. The majority of women were admitted with serious complications like peritonitis (70%), visceral injuries (60%), hemorrhagic and septic shock, renal failure (17.4%), and other conditions like DIC, hepatic failure and encephalopathy. Out of 73 women requiring laparotomy, 22% were done within 24 h of admission and 49% were performed beyond 24-48 h. Conclusion: The present study confirms that education and accessibility of contraception, and readily available, quality abortion services by trained health providers can limit morbidity and mortality arising from unsafe abortion.