Clandestine abortion causing uterine perforation and bowel infarction in a rural area: a case report and brief review.

Carlson B Sama,Fru F Angwafo,Leopold Ndemnge Aminde

doi:10.1186/s13104-016-1926-5

Carlson B Sama, Fru F Angwafo + Show 1 more

Open Access

https://doi.org/10.1186/s13104-016-1926-5

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Abstract

BackgroundAn unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by a person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both. Majority of these unsafe abortions are carried out in rural areas of developing countries, usually by unskilled persons who do not have proper knowledge of the anatomy of reproductive organs and in unhygienic environments thus leading to various complications.Case presentationWe discuss the case of a 21 year old female who presented in septic shock after she underwent an unsafe abortion of an 11 weeks pregnancy with uterine wall perforation and bowel injury that required resection.ConclusionUnsafe abortion is an important public health problem which accounts for a significant cause of maternal mortality and morbidity in resource poor countries. A high index of suspicion of clandestine abortion with ensuing complications should prevail when faced with a woman of child bearing age with the triad of vaginal bleeding, amenorrhea and pelvic sepsis.

Highlights

An unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by a person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both
Unsafe abortion is a public health challenge as approximately 13 % of pregnancy-related mortality worldwide is due to clandestine abortion
Case presentation A 21 year-old female who presented at 11 weeks amenorrhea with complaints of lower abdominal pains and persistent vaginal bleeding mixed with dark clots for the last 4 days

Summary

Conclusion

Awareness about various methods of contraception and easy accessibility to safer methods of abortion should be promoted. A high index of suspicion and detailed clinical assessment are paramount especially in rural settings with limited imaging modalities in order to prevent the ensuing and deleterious complications. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. Authors’ contributions CBS consulted, managed and follow-up the patient, wrote the manuscript. LNA contributed to management and critically revised the manuscript. All authors read and approved the final manuscript. Author details 1 Islamic Medicalized Health Centre, Babessi, Cameroon. Clinical Research Education, Networking and Consultancy (CRENC), P.O. Box 3480, Douala, Cameroon. School of Public Health, Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Australia. Box 3480, Douala, Cameroon. 3 School of Public Health, Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Australia. 4 Gynaeco-Obstetric and Paediatric Hospital, Yaoundé, Cameroon

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