Extensive Uterine Necrosis and Peritonitis Following Clandestine Abortion Attempt: A Case Report

Clandestine abortion remains a prevalent health concern in developing countries, often resulting in severe complications, including uterine secrosis with generalized peritonitis necessitating life-saving hysterectomy, which results in permanent infertility. A 18-year-old primigravida patient presented to our department with severe abdominal pain and vaginal bleeding following a clandestine abortion attempt, 15 days prior. Furthermore, the patient exhibited symptoms of uncontrollable vomiting and diarrhea that began 4 days prior to admission. Upon further examination, she was diagnosed with peritonitis. We performed an emergency laparotomy. It was discovered that the uterus was necrotic and that the foetus was in the abdominal cavity with its placenta. A hysterectomy was necessary to save the patient's life, resulting in permanent infertility. The patient's postoperative course was uncomplicated, and she was discharged from hospital on the 12th day after surgery. This case highlights the need for political and medico-social actions facilitating access to sexual and reproductive education and to voluntary termination of pregnancy in a legal and medicalized context in our regions.