Complications of unsafe abortion in South West Nigeria: a review of 96 cases

Abstract

Background: Induced abortion is common and largely performed under clandestine and unsafe conditions in Nigeria. Complications from such procedures contribute significantly to maternal morbidity and mortality in the country.

Objective: To determine the sociodemographic characteristics and pattern of complications present in patients managed for unsafe abortion.

Setting: The patients studied were treated in Federal Medical Centre, Ido Ekiti, a tertiary health institution located in a rural town and a main referral hospital in Ekiti State, South West Nigeria.

Methodology: The records of patients admitted for complications of unsafe abortion over a 5-year period were analyzed with regard to sociodemographic characteristics, gestational age at termination of pregnancy, the providers, methods used and the complications they develop.

Results: A total of 102 patients were treated for complications of unsafe abortion during the period under review constituting 7.4% of total gynaecological admission. Majority (60.4%) of the patients were less than 25 years old, 74.0% were students while 81.3% were unmarried. Only 9.4% of the women had ever used contraceptives. Of all the cases, 21 (21.9%) were performed within 8 weeks of gestation while 47.9% were performed in the second trimester. Surgical uterine evacuation was the method used in 67.7% of the patients and 65.6% of the abortions were performed by non physicians. Sepsis was the commonest complication in the patients (79.2%) while uterine perforation was present in 12.5% of the women. The case fatality rate was 16.6% and unsafe abortion accounted for 30.8% of all maternal mortality during the period.

Conclusion: As young single nulliparous students are the principal sufferers of complications of unsafe abortion in this study, young persons, especially in-school adolescents, should be targeted for the provision of comprehensive reproductive health services.