Pregnancy outcome after illegal induced abortion in Nigeria: a retrospective controlled historical study

Abstract

The effect of illegal abortion on subsequent reproduction was studied in 46 Nigerian women who gave a history of illegal termination of pregnancy. There was a statistically significant increase in the incidences of premature rupture of membranes, premature labour and low birth weight when compared to 53 primigravida who gave no such history of abortion. The perinatal mortality was also significantly higher in the abortion group. In contrast, pre-eclampsia was less common in the abortion group. These findings indicate that illegal abortion has adverse effects on pregnancy outcome in Nigerian women.

PIP: Researchers compared data on 46 women with a history of illegal induced abortion with data on 53 women with no previous pregnancy to examine the effect of previous abortion(s) on subsequent pregnancy outcome. All 99 women delivered at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Nigeria, during January 1984-December 1988. The type of illegal induced abortion was dilatation and curettage (D&C) which tends to cause cervical incompetence. Controls were more likely to suffer from preeclampsia than cases (11.3% vs. 2.1%; p 0.05). Women with a history of induced abortion were more likely than the controls to suffer premature rupture of fetal membranes and preterm labor (23.9% vs. 1.8%, p 0.001 and 32.6% vs. 9.4%, p 0.0001, respectively). Gestational age was shorter in the study group than in the control group (median, 36 vs. 39 weeks; p 0.01). Cases were more likely than controls to have smaller newborns (2.2 vs. 2.8 kg; p 0.01) and more low birth weight newborns (41.3% vs. 17%; p 0.01). Perinatal mortality was 23.9% in the study group compared to 1.8% in the control group (p 0.001), mainly due to prematurity. Gestational age at termination did not effect the risks of premature rupture of membranes, preterm labor, low birth weight, or perinatal mortality. These findings show that illegal abortion has adverse effects on outcome of subsequent pregnancies. Physicians should determine whether a pregnant woman has had an illegal abortion. If so, they should monitor her for cervical incompetence so they can treat it early. Clinicians performing abortions should use vacuum aspiration rather than D&C to reduce the likelihood of premature labor and perinatal death in subsequent pregnancies.