Pattern of Complicated Unsafe Abortions in Niger Delta University Teaching Hospital Okolobiri, Nigeria: A 4 Year Review.

Background: Abortions performed by persons lacking the requisite skills or in environments lacking minimal medical standards or both are considered unsafe. It is estimated that over 20 million unsafe abortions are performed annually and about 70,000 women die globally as a result, with majority occurring in the developing world. This study aims to determine the pattern of complicated unsafe abortions in Niger delta University Teaching Hospital (NDUTH) Okolobiri.Methods: The study is a four-year retrospective analysis of cases of complicated unsafe abortion managed at the Niger Delta University Teaching Hospital Okolobiri, Bayelsa state.Results: The prevalence of complicated unsafe abortion during the study period was 4.1% of all deliveries and 14.0% of all gynaecological admissions. Majority (55.6%) of the patients had secondary education, while 31.8% were teenagers. Two thirds had a history of previous termination of pregnancy and 87.3% of the patients had never used any form of modern contraceptive. 'Quacks' accounted for 47.6% of the abortions and 53.9% of the abortions were performed late in the first trimester. Genital sepsis, retained products of conception, pelvic abscess and septicaemia were the most frequent complications occurring in 88.9%, 82.5%, 22.2% and 19.1% respectively. Surgical management was employed in 87.3% of the patients. The case fatality ratio was 4.8%, contributing 17.6% of all maternal deaths during the study period. The commonest cause of death was septicaemia (66.7%).Conclusion: There is a high prevalence of unsafe abortions in our environment. It continues to be a major contributor to maternal morbidity and mortality in the Niger Delta. Most of its victims are single adolescent school girls. Efforts directed at reducing unintended pregnancy by comprehensive family planning programs and effective post abortal care services will reduce the problem.Keywords: Unsafe abortion, morbidities, outcome