Induced septic abortion: a major factor in maternal mortality and morbidity.
BACKGROUND
Septic abortion is an infection of the uterus and its appendages following any abortion especially, illegally performed induced abortions. It is characterized by a rise of temperature to at least 100.4 degrees F, associated offensive or purulent vaginal discharge and lower abdominal pain and tenderness.


OBJECTIVE
To study maternal mortality and morbidity in induced septic abortions.


METHODS
Induced septic abortions were analyzed between April 1992 and September 1999 in TU Teaching hospital. Morbidity indicators were surgery other than curettage, prolonged hospitalization and permanent damage.


RESULTS
In 92 cases of induced septic abortions, comprising 6% of total abortions; nine deaths occurred because of disseminated intravascular coagulation, acute renal failure and adult respiratory distress syndrome. Vaginal, intraperitoneal and gum bleeding; epistaxis and malaena resulted in severe anemia (Hb < 6 gm/L) in 11 cases. Wound debridement and skin graft cured two cases of necrotizing fasciitis. One of four conservatively managed tubo-ovarian masses spontaneously drained rectally. In 15 cases laparotomy for pus drainage, salpingectomy, salpingo-oophorectomy, hysterotomy/uterine rent repair was conducted, along with four bowel surgeries and six hysterectomies were performed. Post-operative complications included burst abdomen (one case) and reopened pyoperitoneum, which resulted fecal fistula in three cases, one of these patients died.


CONCLUSIONS
: Induced abortion was proven to be a major detrimental factor for maternal mortality. Morbidity was four times higher than mortality to the extent that patients suffered hemiplegia and forced barrenness.
Rana
Ashma
A
Department of Gynecology and Obsterics, TU Teaching Hospital, Institute of Medicine, Kathmandu, Nepal. ashmarana@hotmail.com
Pradhan
Neelam
N
Gurung
Geeta
G
Singh
Meeta
M
D000031:Abortion, Septic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D009390:Nepal / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies