Complications of uterine instrumentation - a preventable misery on rise
Keywords:Abortion, Illegal. Abortion, Induced. Uterus. Family Planning Services. Abortion Applicants. Uterine Hemorrhage. Uterine Rupture. Maternal Mortality. Peritoneum.
Objective: to determine the intra peritoneal injuries after the illegal uterine instrumentation for illegal abortion. Design: Retrospective study. Place and duration of study: The study was conducted over a period of 3 years in North surgical ward Mayo Hospital, Lahore. Material and methods: 21 patients were included in the study when they present after the illegal instrumentation of uterus for the abortion. Patients were resuscitated and operated in the emergency theatre. Carefully intraperitoneal injuries were recorded and dealt accordingly. Postoperative complications and mortality were recorded. Results: Half of the patients were in the thirties while 4 patients were teenagers. Six patients were unmarried which is approximately 29%. Most of these abortions were done by Dais while 6 were conducted by doctors. Only 35% of the cases present within 24 hours while 28% came to emergency after 10 days of injury. Uterus was injured in more than 76% of cases while fundus is the most common in uterus. Small intestine was damaged in 52%of the patients in which Ileum was injured in 7 patients and jejunum in 4 patients. In 4 patients large intestine was damaged. Ovary and urinary bladder were damaged in one patient each. Resection and exteriorization was done in 14 patients as most of the patients present late and had bad peritonitis. Mortality rate is 5% in our study. Conclusion: Peritonitis is the most common sequel after uterine instrumentation as the unauthorized or untrained personnel mostly do it.
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