Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

Abstract

BackgroundDue to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the induced abortion-related complications in women who were admitted to the Kinshasa Reference General Hospital (KRGH).MethodsThis is a cross-sectional study on 368 obstetric and gynecological patients who were admitted, as emergency cases, to the KRGH during 2014. This health facility was selected because it is a tertiary health facility with an obstetric and gynecological emergency unit most used in the city of Kinshasa. Patient data were collected from patient records and analyzed.ResultsFrom the 368 patients admitted to receive obstetric and gynecological emergency care services in 2014 at the KRGH, 12.2% (95% CI: 9.1–16.1%) had complications due to induced abortion that was significantly diagnosed to adolescents (p < 0.001), single or separated or divorced women or widow(p < 0.001), and to patients with history of one or several induced abortions(p < 0.001). The median duration of hospitalization was ten days and this period of time was significantly longer for the patients who underwent surgery for pelvic peritonitis due to uterine perforation(p < 0.001) compared with the group of patients who underwent Caesarean section/hysterectomy.The mortality rate related to them is 37.8% (95% CI: 23.8–53.5%) with an increase of risk of death in the presence of a post-abortive pelvic peritonitis-type complication, 56.3% of deaths occurred after two days of hospitalization.ConclusionThe complications of induced abortions are a major public health problem due to its frequency among patients admitted to the KRGH, as well as the poor medical management, and mortality percentage related to them. Therefore, there is a need to understand the reason for the poor medical management to fill in and provide an adequate intervention package.

Health facilities’ capability to provide comprehensive postabortion care in Sub‐Saharan Africa: Evidence from a cross‐sectional survey across 210 high‐volume facilities

“…Other factors such as delays in seeking care and reaching the appropriate facilities are also reported in studies from DRC, Kenya, Nigeria, and Zimbabwe. [20][21][22][23] Our study was unable to deduce health professionals' knowledge and practices necessary on the provision of quality care, or their compliance with evidence-based PAC recommendations. However, these are important factors to consider in the capability to provide quality PAC.…”

Healthcare providers’ attitude towards abortion service provision in Gulu city, Northern Uganda

“…Globally, an estimated 20 million induced abortions are being performed unsafely each year leading to signifi cant maternal mortalities and morbidities worldwide [1]. complications of induced abortions are the second leading cause of maternal death [2]. The mortalities and morbidities correlate to poverty, social inequity, and the constant, methodical denial of women's human rights [3] and as such developing countries contribute a bigger share(97%) of the burden [4,5].…”

Midwives’ integration of post abortion manual vacuum aspiration in the Democratic Republic of Congo: a mixed methods case study & positive deviance assessment

“…In 2016, 40,090 women and girls obtained post abortion care with 77% requiring treatment for complications in the capital city of Kinshasa alone [1,7]. Mortality rates for post abortion complications are as high as 37.8% (95% CI: 23.8-53.5%) [8,9] owing to critical gaps in community hospitals' provision of basic delivery services and few referral services for post abortion care [6,7,10,11].…”