Septic Abortions, A Preventable Malady: A Study In A Tertiary Hospital Of Semi-Urban India

Abstract

Background: Though abortion has been legalized in India for over three decades (Medical Termination of Pregnancy Act of 1972), unsafe abortion continues to be a significant contributor of maternal mortality and morbidity due to lack of knowledge of contraception, social pressures and untrained traditional birth attendants and health care providers. Objective: To study the profile of septic abortions, complications faced, and its management Methods: All women with features of septic abortions (n=32) were included. Observations: nearly 72% of our patients were between 26 to 35 years of age, which is the prime reproductive age group, with the majority belonging to lower socioeconomic strata. 81.2% patients underwent MTP mainly due the pregnancy being unwanted and economic issues. These were mainly conducted at home (62.5%) by untrained personnel, but surprisingly MTPs conducted at primary health centers/nursing homes also contributed to unsafe abortions (37.5%). 53% of women had the abortion in the late first trimester. All the patients had leukocytosis (100%), 19 patients presented with deranged coagulation profiles probably due to late referrals, and 53.1% had anemia of varying degrees. Only 12.4% of the cases could be managed successfully by medical treatment without any surgical intervention; the rest of them required some sort of surgical intervention. Conclusion: To reduce the morbidity and mortality associated with septic abortion, intensive dissemination of information and commitment at all levels is required, as is the use of various contraceptive methods to be promoted. Regular training courses for traditional birth attendants (dai), nurses and doctors under the supervision of expert obstetricians is recommended.