Résumé
To determine the frequency of unsafe abortion and its morbidity and mortality in patients presenting at Civil Hospital Karachi Descriptive study. Department of Obstetrics and Gynecology, Unit III Civil Hospital Karachi, from 1st January 2001 to 31st December 2005 All patients with history of induced abortion were admitted. The particulars related to each case like age, marital status, parity, reason for requesting abortion, place and expertise of person carrying out the procedure and outcome were recorded. Once patient arrived in our unit detailed examination was done and relevant investigations sent. After primary resuscitation and optimization, the patients were managed according to their complications in collaboration with general surgical department Fifty nine mostly young ladies with age range of 17 to 47 years and mean age of 30.76 years, presented with complications of induced abortion. Fifty four patients were married and 5 were single mothers. Fourteen patients [24%] were nullipara and remaining 45 [76%] were having 5 or more children. Only 7 out of 59 patients were booked cases, who underwent elective therapeutic medical termination of pregnancy [for foetal congenital anomalies in 5 cases and maternal grade III cardiac disease in 2 cases] They had no complication. Fifty two patients presented with induced and unsafe abortion. They were referred cases, and had multiple complications. Two patiens were brought dead and one patient died during pre-operative resuscitation. Out of remaining 49 patients, five [10%] were managed conservatively, 25 [51%] had re-evacuation and 19 [39%] underwent exploratory laparotomy. Ileal perforation was found in 5 cases. These were treated by primary repair and resection and anastomosis [2 cases each] and ileostomy in 1 case. Sigmoid perforation was found in 3 cases and managed by colostomy. Repair of uterine perforation only was done in 4 cases. Hysterectomy was performed in 4 patients. In three patients peritoneal toilet was also done. Overall mortality was 9.6% [n-5] Our data shows high morbidity and mortality associated with induced unsafe abortion in the form of prolonged hospital stay, multiple blood transfusions, laparotomies, hysterectomies that compromises the obstetrical future of young patients