Abortion, unsafe

Notes
  • An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both (WHO definition).
  • Statistics of unsafe abortion: global incidence-21.6M per year (out of which 18.5M are in developing countries with the most severe morbidity and mortality occurring in sub-Saharan Africa) in 2008; annual mortality rate arising from abortion or its complications globally in 2008 - 47,000; global contribution of unsafe abortion to all maternal deaths in 2008 -13%); proportion of women in Kenya who have reported that their giving birth was either unwanted or mistimed - 43%.
  • Methods that are commonly used to secure unsafe abortions include use of pharmacological abortifacients such as misoprostol (PGE1 analogue) in combination with mifepristone (a progesterone receptor antagonist) or methotrexate, dinoprostone (by the extra-amniotic route in second trimester); efforts to break the amniotic sac inside the womb with a sharp object or wire (fatal) and administration into uterus of toxic chemicals such as potassium permanganate, Lysol and chilli peppers
Symptoms
  • Vaginal bleeding
  • Pelvic and /or back pain
  • Fever
  • Sepsis
  • Shock
  • Tetanus
  • Peritonitis
  • Organ and system failure
Diagnosis
  • Clinical review
Differential
  • Not applicable
Prevention

Unsafe abortion can be prevented by increasing access to counselling services and use of contraceptives when required.

Management
  • Counselling and management of complications.
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