title: Morbidity and mortality due to unsafe abortion in Pakistan.
abstract: OBJECTIVE
  To determine the frequency of women who had undergone an unsafe abortion and attended a tertiary care hospital in Pakistan with complications.
  
  
  METHODS
  Patients with a history of termination at a gestational age of less than or equal to 22 weeks were included in the study.
  
  
  RESULTS
  Of 230 women who met the inclusion criteria, 50 (21.7%) patients had undergone an unsafe abortion and attended the hospital with associated complications. Unintended pregnancy was the reason for the abortion in 82% of women (n=41). Eighteen (36%) underwent terminations performed by doctors, 18 (36%) by Lady Health Visitors (n=18), 10 (20%) by an untrained birth attendant (Dai), and 4 (8.0%) by nurses. Dilatation and evacuation procedures were performed in 28 (56.0%) women, while a Laminaria tent prior to evacuation was used in 18 (36.0%). Major complications included uterine perforation and gastrointestinal injury, observed in 27 (54.0%) women. Hemorrhage was observed in 13 (26.0%) women with retained products of conception after incomplete abortion. Six (12.0%) women died.
  
  
  CONCLUSIONS
  Healthcare providers performed the majority of terminations. To prevent maternal mortality, improved skills through refresher courses and workshops on safer methods are needed.
authors.affiliation: Department of Obstetrics and Gynecology, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan.
authors.forename: Zunaira
authors.initials: Z
authors.lastname: Shaikh
authors.forename: Razia Mustafa
authors.initials: RM
authors.lastname: Abbassi
authors.forename: Naushaba
authors.initials: N
authors.lastname: Rizwan
authors.forename: Sumera
authors.initials: S
authors.lastname: Abbasi
mesh_terms: D000027:Abortion, Incomplete / Q000503:physiopathology; D000028:Abortion, Induced / Q000009:adverse effects* / Q000401:mortality / Q000592:standards; D000293:Adolescent; D000328:Adult; D004107:Dilatation and Curettage; D005260:Female; D041981:Gastrointestinal Tract / Q000293:injuries; D005865:Gestational Age; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007795:Laminaria; D010154:Pakistan; D011247:Pregnancy; D014595:Uterine Perforation / Q000209:etiology; D055815:Young Adult