The magnitude of abortion complications in Kenya.
OBJECTIVE
To estimate and describe the magnitude of abortion complications presenting at public hospitals in Kenya.


METHODS
Cross-sectional descriptive study.


METHODS
Hospital-based. Population Records of all women presenting prior to 22 weeks of gestation with abortion-related complications at selected hospitals during a three-week study period. All public tertiary and provincial hospitals were included; stratified random sampling was employed to select a subset of 54 district hospitals nationwide.


METHODS
Data collectors identified 809 patients with abortion complications on all hospital wards and completed a standardised questionnaire for each by extracting information from the patient's hospital record.


METHODS
Incidence, aetiology, morbidity and mortality of abortion complications.


RESULTS
Most women (80%) presented with incomplete abortion. Approximately 34% of the women had reached the second trimester of pregnancy. Adolescents (14-19 years old) accounted for approximately 16% of the study sample. Manual vacuum aspiration was used to manage 80% of first trimester cases. The projected annual number of women with abortion complications admitted to public hospitals in Kenya is 20,893. The case fatality rate was estimated to be 0.87% (95% CI 0.71-1.02%), so an estimated 182 (95% CI 148-213) of these women die annually. The annual incidence of incomplete abortion and other abortion-related complications per 1000 women aged 15 to 49 years is projected to be 3.03.


CONCLUSIONS
The high rate of abortion-related morbidity and mortality documented in the study highlights the critical need to address the issue of unsafe abortion in Kenya.
Gebreselassie
Hailemichael
H
Ipas Africa Alliance, Nairobi, Kenya.
Gallo
Maria F
MF
Monyo
Anthony
A
Johnson
Brooke R
BR
D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000293:injuries; D003267:Contraception / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D017584:Reproductive History; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data; D014621:Vagina / Q000293:injuries