Complications of induced abortions

To determine the complications developed due to induced abortions. Descriptive case series. Department of Obstetrics and Gynecology, Fatima hospital, Baqai medical University Karachi, from January to December 2005. Records of patients admitted with induced abortion were analyzed retrospectively. Their presentation and complications were noted. Patients presented within 40 days of induced abortion were included in the study. While patients with spontaneous abortions or who were admitted after 40 days of induced abortion were excluded. During study period, total number of patients admitted was 124. Out of them 96 spontaneous abortions, 13 induced and 15 were threatened. The frequency of induced abortion was 10.4%. Out of 13 cases, 9 [69.2%] were married and 4[30.7%] were unmarried under the age of 20 years. Regarding parity 7[53.8%] were having >5 children. Traditional Birth Attendants performed abortions in 11[84.6%] of patients. Sepsis was the main complication developed in 7[53.8%] patients followed by uterine perforation found in 3 [23%] patients. Hemorrhage occurred in 2[15.3%] patients. Induced abortion caused mortality in 1[7.60%] patient. Induced abortions are a major cause of maternal complications. Education of traditional birth attendants to recognize the severity of complications and availability of family planning services can help to reduces morbidities and mortalities

Maternal mortality in a community based hospital

To determine the maternal mortality ratio, frequency of obstetrical causes and disease process leading to maternal mortalities over five years maternity services 2002-06 in a community based hospital. The study was conducted at Fatima Hospital, a tertiary care community based hospital, situated 20km away from Karachi city, covering the population of Gadap Area. The duration of study was from January 2002 - December 2006. All direct and indirect maternal deaths during pregnancy labor and perpeurium were included. The patients who expired after arrival were analyzed from their records. The reason for admission, disease process, cause of death and possible factors responsible for death were identified. The other information included age, parity, booking status, gestational age and relevant features of index pregnancy, along with the distance from hospital was recoded on proforma and analyzed by SPSS Version-11.0. There were total 3,287 deliveries and 2965 live births with 322 perinatal mortalities. Total 37 maternal deaths during five years reveals MMR = 1248 per 100,000 live births. The highest MMR = 2569 was recorded during the year 2004. Majority of the women who died [89.2%] were unbooked. The highest maternal mortality age group was 21-30 years in which 19 [51.4%] mortalities were observed during the entire study period except the year 2004. Out of 37 maternal deaths, 10 [27%] were primigravidas. Obstetrical hemorrhage was the most frequent cause followed by hypertensive disorders, sepsis and suspected pulmonary embolism. On arrival at hospital 4 [10.8%] of patients were dead. SIRS and MODS diagnosed in 14 [37.8%] and 17 [45.9%] of patients. Majority of maternal deaths 25 [67.5%] occurred within 24 hours after delivery. Obstetrical hemorrhage was the leading cause of maternal deaths. Community awareness, training of traditional birth attendants to recognize the seriousness of the disease and improving the referral system can reduce the maternal mortality