Tetanus Infection Complicating an Unsafe Abortion with Resulting Maternal Mortality: A Case Report

Unsafe abortion, though preventable, contributes significantly to maternal morbidity and mortality, especially in countries with restrictive abortion laws. Post-abortal tetanus is a rare but life-threatening complication associated with high mortality. An 18-year-old single P0⁺¹ Senior Secondary School (SSS) 2 student with eight weeks history of amenorrhoea who presented with complaints of generalised spasms, difficulty with speech and a fever of three days duration. This followed an unsafe surgical termination of pregnancy at a patent medicine shop a month before presentation. Her immunisation status was unknown. Examination revealed trismus and generalised muscle rigidity with opisthotonus. Laboratory findings showed leukocytosis (20,000cells/mm³) and mild anaemia (PCV 30%). A clinical diagnosis of septic abortion complicated by generalised tetanus was made. A multidisciplinary team was instituted to care for the patient; she received intravenous fluids, parenteral antibiotics, tetanus toxoid, human tetanus immunoglobulin, analgesics, diazepam infusion for spasm control, and other supportive care in a low-stimulation environment. Despite resuscitative efforts, the patient deteriorated rapidly and died within three hours of admission. Various complications, including tetanus infection, can arise following an unsafe abortion, leading to an increase in our already high maternal mortality rates. Ensuring access to contraception, providing post-abortion care services, promoting adolescent health-friendly services, promoting women's rights, health and status and expanding the legal conditions for abortion will help to curtail this menace.