Complications of induced abortion and miscarriage in three African countries: a hospital-based study among WHO collaborating centers

Goyaux, Nathalie; Alihonou, E; Diadhiou, F; Leke, Robert J. I.; Thonneau, Patrick

doi:10.1080/j.1600-0412.2001.080006568.x

Cited by 29 publications

(8 citation statements)

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“…This study adds to the body of evidence highlighting the significant adverse effects of abortion complications on health outcomes [4,5] by reporting the negative impact of abortion complications on HRQoL, and the mediating role of social support in a resource-limited setting. The study suggests a potential benefit of appropriate social support.…”

Section: Discussionmentioning

confidence: 90%

“…The impact of abortion complications on physical health has also been described. Women who do not die following an unsafe abortion are at risk of short-term consequences including severe bleeding, vaginal and abdominal injury which often result in hospitalization [4,5]. These sequelae are associated with impairment in the performance of one’s usual activities, self-care, mobility and pain and discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to economic impact, the clinical and health consequences of illegally-induced and often unsafe abortions have been described elsewhere [4,5]. However, much less is known about the impact on patient reported outcomes, specifically Health-Related Quality of Life (HRQoL).…”

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life and social support among women treated for abortion complications in western Uganda

Levine

Jenny

Ngonzi

et al. 2013

Health and Quality of Life Outcomes

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BackgroundWhile the impact of abortion complications on clinical outcomes and healthcare costs has been reported, we found no reports of their impact on Health-Related Quality of Life (HRQoL), nor the role of social support in moderating such outcomes. In this study, we performed an assessment of the relationship between abortion complications, HRQoL and social support among women in Uganda.MethodsWe interviewed women who were discharged after treatment for abortion complications and, as a comparison, women visiting a regional referral hospital for routine obstetric care. We administered the EuroQol instrument and the Social Support Questionnaire Short-Form, and collected demographic and socioeconomic data. We performed descriptive analyses using t-tests, Wilcoxon rank-sum tests and chi-square tests, and multivariable linear regressions with interaction effects to examine the associations between abortion complications, EQ-5D utility scores and social support.ResultsOur study included 139 women (70 with abortion complications, and 69 receiving routine obstetric care). In four out of the 5 dimensions of the EQ-5D, a larger proportion of women with abortion complications reported “some or severe” problems than women receiving routine obstetric care (self-care: 42% v 24%, p=0.033; usual activities: 49% v 16%, p<0.001; pain/discomfort: 68% v 25%, p<0.001; and anxiety/depression: 60% v 22%, p<0.001). After adjusting for age, social support, wealth tertile, employment status, marital status, and HIV status, women with abortion complications had a 0.12 (95% CI: 0.07, 0.18, p < 0.001) lower mean EQ-5D utility score than those receiving routine obstetric care. An analysis of the modifying effect of social support showed that a one-unit higher average number of people providing social support was associated with larger mean difference in EQ-5D utility score when comparing the two groups, while a one unit higher average satisfaction score with social support was associated with smaller mean differences in EQ-5D utility score.ConclusionsOur study suggests that abortion complications are associated with diminished HRQoL and the magnitude of the association depends on social support. However, the mediating role of social support in a setting of social and legal proscriptions to induced abortion is complex.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Health-related quality of life and social support among women treated for abortion complications in western Uganda

Levine

Jenny

Ngonzi

et al. 2013

Health and Quality of Life Outcomes

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“…In Benin, abortion is one of the main causes of maternal deaths with a case-fatality rate of 17%. These abortions occur in 81% of cases in young people under 19 years of age with serious or even fatal complications such as 30.6% of cases of hemorrhage [3] [4] [5]. Similarly, unprotected sex is also at the origin of STIs.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitude and Practice of Sexuality and Modern Contraceptive Methods among the Young People at Cotonou (Benin)

Christiane¹,

Dieu²,

Nicholas³

et al. 2018

OJOG

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Introduction: Youth is the period of life when one usually experiences sexual relations for the first time. Lack of preparation and inexperience lead to unwanted pregnancies and sexually transmitted infections. The aim was to study the knowledge, attitudes and practices of sexuality and modern contraceptive methods among young people in Cotonou. Method: This was a descriptive and prospective study that was conducted from August to September 2017 among young people living in Cotonou. Results: We had questioned 500 young people. The sex ratio was 0.6 with 267 girls (61.1%). 27.9% of young people surveyed do not know the fertility period. 76.2% of young people are sexually active and 39.8% have at least 2 sexual partners. Most of these young people had early sexual intercourse at an average age of 16.73 ± 2.85 years. Half of the boys have sex for pleasure and half of the girls have sex for love. 100% of young people know at least one STI, especially HIV/AIDS. Of the 15.10% of cases of reported pregnancy, 49.2% resulted in an abortion. 99% are aware of modern contraceptive methods for the prevention of pregnancy. But 53.7% are unaware that modern contraceptive methods prevent STIs. The main sources of information on contraception are the media and teachers. The main modern contraceptive method used is the condom in 73%. Young people surveyed do not use modern contraceptive methods in 57.5%. Conclusion: The practices of sexuality and modern contraceptive methods remain quite limited among young people. It is important to intensify information and awareness activities.

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“…This results in consumption of large amounts of healthcare resources such as personnel, theatre space, medications, and hospital beds [20]. Some of the women who survive their hospital stay also suffer long-term complications such as pelvic infection, ectopic pregnancy, vesico-vaginal fistulae, urinary incontinence, utero-vaginal prolapse, infertility, and many mental health problems [21-24]. These complications also usually require specialist care and are associated with increased health resource utilization.…”

Section: Introductionmentioning

confidence: 99%

Estimating the costs of induced abortion in Uganda: A model-based analysis

et al. 2011

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BackgroundThe demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda.MethodsA decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty.ResultsThe average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average.ConclusionInduced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

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Complications of induced abortion and miscarriage in three African countries: a hospital-based study among WHO collaborating centers

Cited by 29 publications

References 0 publications

Health-related quality of life and social support among women treated for abortion complications in western Uganda

Health-related quality of life and social support among women treated for abortion complications in western Uganda

Knowledge, Attitude and Practice of Sexuality and Modern Contraceptive Methods among the Young People at Cotonou (Benin)

Estimating the costs of induced abortion in Uganda: A model-based analysis

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