[Post-abortum peritonitis pelviperitonitis at the Androva Mahajanga University Hospital: 23 cases]

In many underdeveloped countries, illegal abortion can lead to death or sequelae. Pregnancy termination is illegal in Madagascar except for medical reasons. We report 23 observed between April 1990 and December 1994 at the Androva Mahajanga University Hospital. Post-abortum infectious complications ranked 19th for hospital admissions. Peritonitis was the most frequent (70%) and most serious complication. The women were young (mean age 24 years, 44% under the age of 20 years). Thirty percent were primigravidae and had poor living conditions (74% were homemakers and 13% were students; 44% were single). Clinical signs were malodorous loss and abdominal pain. A surgical procedure was performed in 74% of the cases: 3 salpingo-oophoectomies, 2 hysterectomies and 10 uterine sutures. Mortality was high, 13%. Illegal abortion must be prevented with better information on contraception and better health education programs. The question of the usefulness of current legislation is discussed.