Abstract

Background Abortion-related mortality is decreasing, but the complication is still causing a significant morbidity to mothers especially in developing countries. Recently, suitable criteria to assess maternal near miss for sub-Saharan countries were adapted in harmony with the previous World Health Organization near-miss criteria. The aim of this study was to assess the magnitude of severe acute maternal morbidity and associated factors related to abortion in Hawassa University Comprehensive Specialized Hospital, Ethiopia. Method An institution-based cross-sectional study was conducted among 337 women who sought abortion services at Hawassa University Comprehensive Specialized Hospital from January 1 to October 30, 2019. The participants were selected conveniently. Data was collected by using prospective morbidity methodology with pretested anonymous structured English questionnaire. The collected data were then entered into SPSS version 20 for analysis. Variables with p value ≤ 0.2 in the bivariate analysis, not collinear, were entered to multivariable regression. The strength of association is presented by odds ratio and 95% confidence interval. p value less than 0.05 was used as a cut-off point to determine statistically significant association. Results The magnitude of severe acute maternal morbidity and maternal near miss is found to be 35.6 and 17.7%, respectively. Factors significantly associated with severe acute maternal morbidity were as follows: women uneducated (AOR: 3.02; 95% CI 1.24-7.33), second-trimester pregnancy (1.89-9.14), and delayed presentation (AOR: 4.32, 95% CI 1.76-10.59). Conclusion Severe acute maternal morbidity and maternal near miss related to abortion are high despite the availability of safe termination. Near-miss cases could be better traced by using reasonably adapted World Health Organization near-miss criteria for sub-Saharan countries. Lack of education, increased gestational age, and delayed presentation had increased severe acute maternal morbidity associated with abortion which may need further education on health care seeking culture of the community.

Highlights

  • Maternal mortality due to abortion is decreasing both worldwide and in Ethiopia [1,2,3]

  • Suitable criteria to assess maternal near miss for sub-Saharan countries were adapted in harmony with the previous World Health Organization near-miss criteria [9]

  • Lack of education, increased gestational age, and delayed presentation had increased complications associated with abortion

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Summary

Introduction

Maternal mortality due to abortion is decreasing both worldwide and in Ethiopia [1,2,3]. During 1980-1999, abortionrelated complication was the leading cause of maternal mortality in Ethiopia, accounting for 31% This steadily decreased to 10% during the period 2000-2012 [2]. Abortion-related mortality is decreasing, but the complication is still causing a significant morbidity to mothers especially in developing countries. The aim of this study was to assess the magnitude of severe acute maternal morbidity and associated factors related to abortion in Hawassa University Comprehensive Specialized Hospital, Ethiopia. Factors significantly associated with severe acute maternal morbidity were as follows: women uneducated (AOR: 3.02; 95% CI 1.24-7.33), second-trimester pregnancy (1.89-9.14), and delayed presentation (AOR: 4.32, 95% CI 1.76-10.59). Lack of education, increased gestational age, and delayed presentation had increased severe acute maternal morbidity associated with abortion which may need further education on health care seeking culture of the community

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