Monitoring Incomplete Abortion Care at Dacca Medical College

Abstract

Over the May 1977 to April 1978 period a total of 1003 cases of complicated abortion were admitted in the Dacca Medical College Hospital, Bangladesh and were treated for threatened, inevitable, incomplete, or missed abortion. This report presents the sociodemographic profile, pattern of complications, contraceptive practice history, and other clinical and nonclinical experiences of these 1003 women with induced or spontaneous abortions, in a comparative frame. Of the 1003 patients, 243 (24.2%) reported as having deliberately induced the abortion process and 760 (75.8%) were reported as having spontaneous abortions. Follow-up data were recorded for 97.0% of the patients. Data were recorded on standard hospital abortion study forms. Nearly 2/3 of the patients lived in urban areas. A greater proportion of women living in the slum area had induced abortions (13.2%) than those who had spontaneous abortion (7.6%). 98.9% of the women were married. 55.3% of the women were in the 20-29 year age group. The induced abortion group was, on the average, about 5 years older than the spontaneous abortion group, with the mean ages of 30.5 years and 25.4 years, respectively. 75.6% of the women did not have any education. The induced abortion patients had on the average 5.4 live births as compared to only 2.2 live births for the spontaneous abortion patients. Overall, 6.5% of induced abortion patients and only 0.1% of spontaneous abortion patients reported having induced abortion previously. 79.4% of the patients were categorized as having incomplete abortion at the time of admission, and the remaining patients were categorized as having inevitable abortion in 9.8%, threatened abortion in 7.8%, complete abortion in 2.3%, and missed abortion in 0.7% of cases. A relatively greater proportion of spontaneous abortion patients (83.3%) than induced abortion patients (28.4%) did not have any major complications at the time of admission. A large proportion of women with induced abortion were admitted with sepsis or pelvic infection (35.8%) and with above normal temperatures (23.0%). The most frequent complication among spontaneous abortion patients was excessive bleeding (13.4%). According to the patients, the most frequently used method to induce abortion was the intake of oral abortifacients (77.8%). In 18.9% of the cases solid objects were introduced through the cervix to terminate the pregnancy. The treatment of the largest proportion of cases consisted of curettage with antibiotic therapy. The overall mortality rate was 18/1000 admissions and was primarily due to complications at the time of admission. Among the induced abortion patients 60.5% practiced contraception in the past in contrast to 17.2% among the spontaneous abortion patients.