Complicated induced abortion in Sagamu, Nigeria

A review of cases of induced abortion managed at Ogun State University Teaching Hospital, Sagamu from January 1988 to December 1997 is presented. One hundred and two cases were treated for various complaints and complications of induced abortion during the period of review. The mean age in years was 24.6+/-5.8. The groups 20-24 years, 15-19 years and 25-29 years constituted 39.2%, 23.5% and 18.6%, respectively, of the patients. Mean parity was 1.7+/-1.8. Thirty-eight point two per cent, 30.4% and 17.6% were para zero, 2-4 and 1, respectively. Fifty-one per cent of the patients were single. Thirty-four point three per cent, 15.7% and 2.0% of the patients have had one, two and three induced abortions before. Forty-five point one per cent of the patients refused to disclose where and who performed the abortion, while 31.4%, 10.8% and 7.8% of the abortions were carried out by physicians, quacks and nurses. Forty-five point one per cent of the patients procured the abortion at the gestational age of 13-24 weeks, while 26.5% waited for 10 days and over after the abortions before seeking for medical help. Thirty-six point eight per cent and 26.3% of operators in fatal cases were physicians and nurses, respectively. The mean admission interval after abortion for fatal cases was 11.1+/-3.2 days and 4.0+/-3.5 days for other cases that survived and the difference was significant (t=8.0930; P<0.001). Eighty-five point three per cent had never used any form of contraception. Seventy-nine point four per cent, 61.8% and 6.9% of the patients presented with bleeding per vaginam, abdominal pains and fever, respectively. The most common complications were anaemia (56.9%), haemorrhages (46.1%), sepsis (33.3%) and maternal death (18.6%). The maternal mortality ratio was 18 627.5 per 100 000. The difference between maternal mortality ratio due to abortion and the general population (1578.9) was statistically significant (chi(2)=126.4281, P<0.001). Sunction aspiration (76.5%) and exploratory laparatomy (9.8%) were the most common operations performed. The findings in this series further highlight the urgent need to eliminate or reduce substantially the factors responsible for septic induced abortion.