Magnitude of induced abortion and quality of post abortion care at kenyatta national hospital, nairobi, kenya.

Abstract

Background An estimated 46 million pregnancies in the world end in induced abortion each year. Nearly 20 million of these are unsafe. About 13% of pregnancy related deaths have been attributed to complications of unsafe abortion. Unsafe abortion contributes significantly to maternal mortality in resource poor countries. In Kenyatta National Hospital a total of 7 to 10 patients with abortion are treated daily. Objective The objective was to determine the magnitude of induced abortion and quality of post abortion care at Kenyatta National Hospital. Methods This was a cross sectional study. The study population comprised of all patients with abortion who were treated at acute gynaecological unit of Kenyatta National Hospital over duration of two months. Results The mean age of the study participants was 25.9yrs. Majority (80.2%) were below 30 Yrs and most (58%) were of low socioeconomic status. Magnitude of induced abortion was at 38%. About 16% of the patients had complications, haemorrhage being the commonest at 58.8%, sepsis 41.2%, uterine perforation 11.8%, 2% died and 2% had intestinal injuries. Manual Vacuum Aspiration was the commonest (83%) uterine evacuation method that was used for management of incomplete abortion. Post abortion counselling and provision of family planning was at 85%. Conclusions Magnitude of Induced abortion was high at 38%, young people below 30 Yrs formed majority of post abortion care patients. Manual Vacuum Aspiration was the commonest uterine evacuation method used. Haemorrhage and sepsis were the commonest complications seen. Majority of the participants received Post abortion counselling and provision of family planning. Recommendations To strengthen primary intervention measures, family planning to avoid unwanted pregnancies and thus reduce the magnitude of induced abortions and the guidelines of comprehensive abortion care to be revised and encourage use of medical management in the abortion patients who meet the criteria for its use.