Bhutta S Z, Aziz S, Korejo R.
Surgical complications following unsafe abortion.
J Pak Med Assoc Jan ;53(7):286-9.

Objective: To determine the severity of complications of unsafe abortion and optimum ways of managing them. Setting: Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Center, Karachi. Material and Methods: Ninety three women presenting with complications of unsafe abortion were followed up by interviews and records from case files, admission, operation theater and discharge registers. Age, parity, marital and socioeconomic status of these women was recorded. The clinical features, period of gestation, method used and status of abortionist were noted. The details of management, complications and outcome were also analysed. Results: Majority (51%) were married women aged between 26 and 35 years. Grandmultiparae constituted 40.5% and only 14%, including 9 unmarried women were primigravida. Untrained birth attendants performed the procedure in 32% and doctors in 30%. Instrumentation of the uterus was the commonest method of induction, used in 65% of cases. Some form of surgical intervention was required in 90%. Septicaemia, bowel injury and haemorrhagic shock were significant complications, while the mortality rate was 10%. Conclusions: Only women with significant complications after unsafe abortion are likely to present to hospital, therefore optimal, timely management, including surgical intervention is indicated to improve outcome (JPMA 53:286;2003).

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