Reproductive health in developing countries: a new initiative

Pattern of morbidity and mortality following illegal termination of pregnancy at Nnewi, Nigeria

Seventeen women were treated for complications of illegal termination of pregnancy over a 2-year period, January 1996 to December 1997. Important characteristics of the women include a mean age of 21 years (mode 18 years) and being unmarried (100%, n=17), nulliparous (94%, n=16) and unemployed (76%, n=13). There was a tendency towards late termination as 50% of women had a termination after 13 weeks. Serious complications were cervical laceration, pelvic abscess/peritonitis, ruptured uterus, transection of the sigmoid colon and ileal/jejunal lacerations. The mortality rate was 6% (n=1). Most of the terminations were performed through instrumental cervical dilatation without prior medical or hydrophilic treatment. This study shows that illegal abortions are still commonly performed in Nigeria with an unacceptably high incidence of morbidity and mortality. Modernisation of abortion laws, wider contraceptive usage, adoption of modern methods of termination of pregnancy (RU 486 and prostaglandin E(1) analogues) and prophylactic antibiotics are recommended in order to reduce the problems of unsafe abortion in Nigeria and other developing countries.