Background: Medical termination of pregnancy has been legalized in India since 1971. Medical abortion pill is well effective in early weeks of pregnancy. It is safe only when it is used under medical supervision. This study was carried out to analyse the complications following self-medication of abortion pills and to suggest measures to prevent such practice.Methods: This was a retrospective observational study conducted at our hospital from March 2017 to July 2017.Results: In present study 30 (75%) patients were in age group of 20-30 years. Illiterate patients were 22 (55%). Half of the patients, 20 (50%) were having three or more than three children. Majority of women 30 (75%) had consumed the abortion pills 1-10 days before coming to the hospital and 14 (35%) of patients had come with complain of excessive bleeding per vagina. Incomplete abortion was present in 32 (80%) of patients. Instrumental evacuation was required in 28 (87.5%) patients. Laparotomy for ruptured ectopic and rupture uterus was performed in 1 (2.5%) of each patient. 6 (15%) patients were severely anaemic. Transfusion of blood was required in 9 (22.5%) of patients.Conclusions: Medical abortion is effective and safe when carried out under medical supervision. Unsupervised use of medical abortion pills was associated with many complications like incomplete abortion, rupture ectopic and ruptured uterus. So, over the counter sale of medical abortion pill should be restricted.
Background: Intra Uterine Fetal Death (IUFD) is an important issue in modern obstetrics. This study has been undertaken to find out the incidence of IUFD, socio-demographic factors, probable etiological factors, mode of delivery, its outcome and complications if any.Methods: This retrospective observational study was carried out at a tertiary care hospital. Data was collected from case papers of patients who have delivered beyond 20 weeks and/or baby weighing more than 500 grams and having IUFD prior to onset of labor or during labor with singleton pregnancy.Results: Incidence of IUFD was 17.2 per 1000 births. Majority of the patients 93 (48.1%) were in age group of 26-30 years, 115 (59.5%) came as an emergency and 94 (48.7%) were primi gravida. Majority 89 (46.1%) patients had not taken any antenatal visit. IUFD occurred due to unexplained etiology, pre-eclampsia-eclampsia, anemia, uncontrolled diabetes, jaundice, antepartum haemorrhage and congenital malformation in 77 (39.9%), 51 (26.4%), 10 (5.1%), 7 (3.6%), 4 (2%), 29 (15%) and 2 (1%) respectively. Vaginal delivery occurred in 151 (78.2%). Majority of dead babies 111 (57.5%) were male, 71 (36.7%) were weighing 1kg or less and 92 (47.6%) were macerated. Emotional upset, DIC, PPH and ARF occurred in 193 (100%), 21 (10.8%), 15 (7.7%) and 1 (0.5%) respectively.Conclusions: Majority of patients were unregistered and had not taken antenatal care or had inadequate antenatal care. Pre-eclampsia-eclampsia, APH, anemia and diabetes were the leading cause of IUFD along with unknown causes. A significant proportion of IUFD can be prevented by health education regarding adequate antenatal care, warning signs and institutional deliveries.
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