Abortion care in a teaching hospital in Ghana

Abstract

Regardless of whether an abortion is spontaneous or induced, subsequent events and the care received determine whether the abortion is safe or unsafe [1]. Unsafe abortion causes a global average of 13%, and in some countries up to 50%, of all maternal deaths [1]. In developing countries complications of abortion also result in significant morbidity.

Postabortion care is a strategy that aims to strengthen the capacity of health institutions to offer three integrated components of care, namely emergency treatment for abortion complications, postabortion family planning counseling and services, and links between emergency treatment and other reproductive health services.

This retrospective study reviewed the case notes of all patients with complications of abortion including incomplete abortion admitted to the Korle‐Bu Teaching Hospital (KBTH) in Ghana, from January 1 to December 31, 2000. The data were analyzed by the Statistical Package for Social Sciences (spss), version 9.

There were a total of 3689 admissions to the acute Gynecology wards of which 1502 (40.7%) were due to complications of abortion. Two others which were complicated by tetanus, were admitted to the Fevers’ Unit (Infectious Diseases’ Unit). Of the total of 1504 cases, 1152 (76.6%) were spontaneous abortions, 282 (18.6%) induced abortions and 70 missed abortions.

The overall complication rate was 13.4% (202/1504). Thirty percent (86/282) of those with induced abortion had significant complications in contrast to 9.8% (113/1152) of those with spontaneous abortion. If septic abortion, pelvic peritonitis and pelvic abscess were taken as degrees of sepsis, then sepsis contributed approximately 48.5% (98/202) of all the complications while anemia occurred in approximately 47.0% (95/202; Table 1). Straightforward incomplete abortions were excluded in this analysis.