Abortion procurement and post-abortion care services: experiences of nigerian adolescents

Introduction: The prevention of abortion related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, Nigerian adolescents are often unable to obtain adequate post-abortion care services due to numerous challenges and barriers. This study attempted to explore experiences with abortion and post abortion care services from the adolescents' perspective which is the first step in enhancing optimal utilization of adolescents' PAC services. Methods: A qualitative exploratory research design was used. Twenty semi-structured interviews were conducted with adolescent patients during hospitalization. The adolescent patients were duly counseled and informed consent obtained prior to the in-depth interview. Semi-structured interview guide was used for data collection and the data were analyzed using content analysis. Results: Findings from the interviews revealed that adolescents found it difficult to discuss issues of pregnancy and abortion with their parents or guardians due to fear, stigmatization or rejection. The adolescents experienced negligence of care, shame and stigma due to failure of health care providers to ensure privacy, as well as delay in treatment due to hospital protocol and non availability of prescribed drugs which significantly affected the PAC care services they received. Conclusion: The adolescents experienced fear, shame, and stigmatization, negligence of care and lack of access to adequate PAC services. These findings highlight the need to review health actions directed towards adolescents with abortion complications and plan interventions aim at improving provision of adolescents' friendly PAC services, in order to meet the reproductive health needs of these adolescents

Characteristics of patients presenting with complications of abortion in a tertiary health facility in south-west Nigeria

Objectives: Abortion is associated with significant health problem with short- and long-term complications that affect the quality of life of those who are fortunate enough to escape mortality. This study evaluated the population of patients with complications of abortion; identified the abortion providers and the pattern of contraceptive usage in these patients managed in our hospital; and suggests strategies on the required heath intervention.Design: The design was a descriptive study of cases of abortions with complications. Setting and subjects: We reviewed all (225) cases of abortions with complications managed at Ladoke Akintola University of Technology Teaching Hospital; Osogbo; Nigeria; over a five-year period. Outcome measures: Records of patients managed for abortion-related complications were retrieved; data were extracted and analysis was carried out for socio-demographic factors and other abortion-related characteristics. Results: The study showed a more common occurrence of abortions among middle-aged (64.4); multiparous (53.3) women with a low socio-economic background (62.6); and they were performed mostly by medical doctors in private settings (37.8). The low usage of contraception (11.1) was of significance. Conclusion: This study provided considerable insight into the complications of abortion in a tertiary institution in Nigeria. Most of the patients were aware of contraception; but usage; which mainly constituted emergency contraception; was low. Despite prophylactic antibiotics; sepsis was the most common observed complication. Healthcare intervention should be re-focused through the encouragement of the adoption of effective methods to prevent unwanted pregnancies. Healthcare providers should re-appraise their antibiotics regimen

Use of Foley's catheter and prostaglandin F-2 alpha in second trimester termination of pregnancy

Termination of pregnancy [TOP] in the second trimester is associated with three to five times higher risk of maternal morbidity and mortality than termination during first trimester. The main concern of obstetrician is to provide the most effective and safest regimen which combines the shortest expulsion interval with least side effects. This study was undertaken to compare the use of Foley's catheter with extra-amniotic instillation of PGF2 alpha for second trimester TOP so that a choice of the safer and cost-effective method could be available. The study was conducted in Department of Obstetrics and Gynecology Unit 'B' at Ayub Teaching Hospital Abbottabad between August 2003 and July 2004. Sixty patients recommended for TOP [missed abortion or anencephalic fetus confirmed on ultrasonography] were randomly allocated into two groups. In group 'A', Foley's catheter alone was used while in group 'B' extra amniotic instillation of Prostaglandin F-2 alpha [PGF2 alpha] was done via a Foley's catheter. After expulsion of catheters in both cases oxytocin infusion containing 30 units were started till the expulsion of fetus, placenta and membranes. The mean induction to expulsion time and the mean induction to delivery time for both groups were noted as well as total cost of treatment. Difference in time interval with regard to induction to expulsion time of catheter and induction to delivery time between the two groups was significant being 3 hours and 5 hours respectively less in group 'B' [p < 0.001]; however only 25% of patients in group 'B' had a significant short induction to delivery time as compared to group 'A'. The difference in costs of treatment between the groups was also significant [p < 0.001]. Use of PGF 2 alpha is preferred, though for poor patients Foley's catheter may be used, but only in a tertiary care setting

Investigaçäo sobre ocorrência de aborto em pacientes de hospital de centro urbano do Estado de Säo Paulo, Brasil / The occurrence of abortion in impatients of hospitals of urban centers of the State of Säo Paulo, Brazil

Propöe-se identificar determinadas características de natureza biológica, demográfica, social e institucional com base nas informaçöes registradas nas fichas de prontuário de 2.588 mulheres atendidas com complicaçöes de aborto em um hospital de Santo André, zona urbana e industrializada da Grande Säo Paulo (Brasil), no período de janeiro de 1978 a dezembro de 1982. Os dados revelaram uma duplicaçäo no número de mulheres com complicaçöes de aborto no período estudado, elevando-se gradualmente de 302 em 1978 para 672 em 1982. O número de partos atendidos no mesmo hospital, näo obstante, cresceu em apenas 14 por cento no mesmo período, obtendo-se a média de relaçäo aborto/parto: 1:3,6 e 1:1,8 em 1978 e 1982, respectivamente. A maioria da populaçäo estudada (60 por cento) possuia ocupaçäo assalariada näo especializada. A idade (16,4 por cento das mulheres estudadas eram menores de 20 anos) apresentou relaçäo estatisticamente significativa com o estado marital, cor, ocupaçäo e resultados gestacionais. Houve correlaçäo significativa entre idade na menarca, idade na primeira relaçäo sexual e idade na primeira gravidez, no grupo de mulheres primigestas

Protocolo de atencion de enfermeria a pacientes septicas post-aborto en el Hospital de Kennedy durante el periodo de noviembre 1988 - marzo 1989 / Nursing care protocol for post-abortion septic patients in Hospital Kennedy during the period november 1988 - march 1989

Este trabajo de investigacion sobre el protocolo de atencion de enfermeria para pacientes septicas post-aborto, concede una importancia fundamental y decisiva a la accion de enfermeria cada dia mas organizada y en proceso de expansion ante un problema evidente de caracter social como es el aborto y mas especificamente el aborto septico. Por tal motivo se elaboro un protocolo que contemplo las actividades de enfermeria encaminadas a brindar una adecuada atencion a las pacientes septicas post-aborto en el Hospital de Kennedy. Luego del estudio se pudo concluir que: -La mayor frecuencia de aborto septico se encontro en mujeres jovenes en edad reproductiva, coincidiendo con el inicio de la actividad sexual. -El aborto septico en la mayoria de los casos resulta como consecuencia de las maniobras abortivas realizadas en mujeres pertenecientes al nivel socioeconomico medio-bajo que asisten a dicho hospital. -Se detecto en el grupo de estudio que el soporte emocional fue nulo, teniendo encuenta que este es prioritario para las pacientes septicas post-aborto, ya que los procedimientos a los que se ve sometida interfieren y/o influyen en su integridad fisica y psicologica creando sentimientos de culpa..