Socio-demographic characteristics of adolescent post-abortion patients in Blantyre, Malawi.

BACKGROUND: Unsafe sex, unwanted pregnancy and unsafe abortion are some of the emerging adolescent reproductive health challenges in Malawi. OBJECTIVES: To study socio-demographic characteristics of adolescent post-abortion patients and that of their male partners, with the aim of better understanding the determinants of adolescent fertility in Malawi, thus facilitating design of appropriate intervention strategies. DESIGN: A descriptive, cross-sectional study. SETTING: The Queen Elizabeth Central Hospital, Blantyre, Malawi. SUBJECTS: A total of 446 out of 465 eligible adolescents managed for incomplete abortion during the study period were enrolled from January 1st to December 31st 1997. RESULTS. Their mean age was 17.5 years (SD +/- 1.3), while that of their male partners was 22.4 years (SD +/- 3.4). The unmarried adolescents comprised 43.9% and students 38.6%. About 30.0% had attained secondary school level of education. The mean age at sexual debut was 15.7 years (SD +/- 1.75), about a year after that at menarche (14.3 years, (SD +/- 1.4)). The mean number of sexual partners they had had was 1.5 (SD +/- 0.86), the highest being 10. The index pregnancy was reportedly unwanted in 45. 1% of the total. The rate was higher among the young, single and students. They were also less likely to have informed their partners about the pregnancy or the abortion (p = 0.0001). About 52.8% of the female students were involved with fellow male students. Of the married adolescents, 4.4% reported having had extramarital affairs. CONCLUSION: There is need to design appropriate programmes to promote safe sex and reduce unwanted pregnancy and unsafe abortion with its potential sequelae among adolescents in Malawi.

Antepartum and postpartum haemorrhage in primary cervical choriocarcinoma: case report.

Primary cervical choriocarcinoma is very rare. So far only about 60 authenticated cases have been reported in the English literature. Primary cervical choriocarcinoma presenting with antepartum or postpartum haemorrhage is even rarer. A case of primary cervical choriocarcinoma with an apparently normal intrauterine pregnancy, in a 36 year old Malawian African woman, presenting with antepartum haemorrhage at 28 weeks of gestation and later with secondary postpartum haemorrhage is reported. The primary cause in this case was not quite certain. Though rare, it is suggested that cervical choriocarcinoma should be considered a possible local cause of antepartum and or postpartum haemorrhage in a parous woman, in areas where gestational trophoblastic disease (GTD) is relatively commoner, such as Africa.