Abstract
Objective: To find out clinical presentation and outcome of unsupervised use of misoprostol as abortifacent among adolescents presenting with abortion complications. Methods: Case series of thirty one adolescents that presented with abortion complications following unsupervised use of misoprostol. Results: Over a period of 3 years, 31 adolescents were seen, with median age of 17 years. Twenty nine (93.5%) were unmarried and 22 (71%) were in secondary school. Pregnancy duration was 3months and above in 23 (74.2%) of the patients. The cumulative dose of misoprostol tablet ingested was 2 (400 µg) in 17 (54.8%) of the patients. Twenty three (74.2%) patients presented with incomplete abortion with mild sepsis while the remaining 8 (25.8%) patients were admitted and managed with incomplete abortion with severe sepsis. Treatments offered were manual vacuum aspiration in 23 (74.2%) patients, evacuation of retained product of conception under anaesthesia in 7 (22.6%) patients and 1 (3.2%) patient had laparotomy with uterine repair following inadvertent uterine perforation complicating curettage for incomplete abortion. Complications encountered were anaemia 67.7%, uterine perforation 3.2%, blood transfusion 9.7% and diarrhoea in 8 (25.8%) patients. Conclusion: Demedicalise abortion with misoprostol due to improper dosing protocol may be associated with incomplete abortion and its sequelae in an uninformed adolescent population. Establishment of adolescent friendly medical centre that offers post abortion care will go a long way in alleviating this problem.
Highlights
The current generation of adolescents are more than a billion and they will be the largest generation in history making the transition from children to adulthood [1]
We studied adolescents presenting with complications of abortions following the use of self prescribed misoprostol in an at
Adolescents are more vulnerable to unwanted pregnancy and its complications because of secrecy surrounding sex at an early age due to peculiar socio-cultural background in most African Societies
Summary
The current generation of adolescents are more than a billion and they will be the largest generation in history making the transition from children to adulthood [1]. The transition period of adolescence is characterized by the onset of sexual relationships, marriage and child bearing. The biological and social impact of sexual activity in adolescence is associated with more conesquences in females than their male peers [1]. These consequences have been shown to conspicuously and untowardly shape the future of the female adolescent. The resultant delay in marriage coupled with low contraceptive prevalence typical of most developing countries, results in unwanted pregnancy [2]. Over 69,000 of these deaths occur in developing countries while 23,000 occur in sub-Saharan African countries alone, representing an estimated 680 deaths per 100,000 abortion procedures in Africa [3]
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