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 quantitative information exists on national levels of abortion activity major health related sequelae of unsafe abortion or the quality of routine medical care provided to postabortion patients in countries where induced abortion is legally restricted Methods: Researchers used random sampling procedures to select 569 public-sector hospitals in Egypt, and asked designated medical staff to complete a medical abstract form for each 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 other sources, to estimate the rate of induced abortion in Egypt. Results: Among the 22,656 admissions to the obstetrics and gynecology departments during the 30-day study period, approximately one of every five patients (19%) was a woman admitted for treatment of an induced or spontaneous 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 more signs of trauma and 5% had one or more signs of infection. Dilatation and curettage under general anesthesia was the principal surgical treatment provided. Conclusions: Treatment for complications from unsafe abortion consumes substantial resources within the Egyptian health care system. Postabortion care could be improved if vacuum aspiration under local anesthesia were used as the primary postabortion treatment, and if adherence to antiseptic measures were increased.