THE POSTABORTION CASELOAD IN EGYPTIAN HOSPITALS - A DESCRIPTIVE STUDY

Context: Despite international calls to recognize unsafe abortion as a serious health problem in developing countries, very little quantitat ive information exists on national levels of abortion activity major h ealth related sequelae of unsafe abortion or the quality of routine me dical care provided to postabortion patients in countries where induce d abortion is legally restricted Methods: Researchers used random samp ling procedures to select 569 public-sector hospitals in Egypt, and as ked designated medical staff to complete a medical abstract form for e ach postabortion patient admission during a continuous 30-day period. Data were analyzed to assess the state of postabortion care in Egypt, and using data from the 1995 Egypt Demographic and Health Survey and o ther sources, to estimate the rate of induced abortion in Egypt. Resul ts: Among the 22,656 admissions to the obstetrics and gynecology depar tments during the 30-day study period, approximately one of every five patients (19%) was a woman admitted for treatment of an induced or sp ontaneous abortion. Projections yielded an estimated induced abortion rate in Egypt of 14.8 per 100 pregnancies. The mean gestational age of the lost pregnancies was 10.8 weeks, and a large majority (86%) were lost at 12 weeks or less. Fourteen percent of the women arrived at the hospital suffering from excessive blood loss, 1% exhibited one or mor e signs of trauma and 5% had one or more signs of infection. Dilatatio n and curettage under general anesthesia was the principal surgical tr eatment provided. Conclusions: Treatment for complications from unsafe abortion consumes substantial resources within the Egyptian health ca re system. Postabortion care could be improved if vacuum aspiration un der local anesthesia were used as the primary postabortion treatment, and if adherence to antiseptic measures were increased.