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Overview of abortion cases with severe maternal outcomes in the WHO M ulticountry S urvey on M aternal and N ewborn H ealth: a descriptive analysis
Author(s) -
Dragoman M,
Sheldon WR,
Qureshi Z,
Blum J,
Winikoff B,
Ganatra B
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12689
Subject(s) - abortion , medicine , maternal death , obstetrics , gestation , pregnancy , psychological intervention , curettage , pediatrics , gynecology , population , environmental health , surgery , nursing , genetics , biology
Objective To summarise individual and institutional characteristics of abortion‐related severe maternal outcomes reported at health facilities. Design Secondary analysis of data from the WHO M ulticountry S urvey on M aternal and N ewborn H ealth. Setting 85 health facilities in 23 countries.Sample 322 women with abortion‐related severe maternal outcomes. Methods Frequency distributions and comparisons of differences in characteristics between cases of maternal near miss and death using F isher's exact tests of association. Main outcome measures Individual and institutional characteristics and frequencies of potentially life‐threatening conditions, and interventions provided to women with severe maternal outcomes, maternal near miss, and maternal death. Results Most women with abortion‐related severe maternal outcomes ( SMO s) were 20–34 years old (65.2%), married or cohabitating (92.3%), parous (84.2%), and presented with abortions resulting from pregnancies at less than 14 weeks of gestation (67.1%). The women who died were younger, more frequently without a partner, and had abortions at ≥14 weeks of gestation, compared with women with maternal near miss ( MNM ). Curettage was the most common mode of uterine evacuation. The provision of blood products and therapeutic antibiotics were the most common other interventions recorded for all women with abortion‐related SMO s; those who died more frequently had antibiotics, laparotomy, and hysterectomy, compared with women with MNM . Although haemorrhage was the most common cause of abortion‐related SMO , infection (alone and in combination with haemorrhage) was the most common cause of death. Conclusion This analysis affirms a number of previously observed characteristics of women with abortion‐related severe morbidity and mortality, despite the fact that facility‐based data on abortion‐related SMO suffers a number of limitations.