Prevalence of Self Induced Abortion by Self-Administration of Abortive Pills among Abortion-related Admissions in a Tertiary Care Centre

Abstract

Introduction: Each year, unsafe medical abortion costs the lives of thousands worldwide. Despite the legalization of abortion in Nepal in 2002, many still seek services from unauthorized sources. This has led to grave consequences including death. Our objective is to find out the prevalence of self-induced abortion by self-administration of abortive pills and related complications.
 Methods: It is a descriptive cross-sectional study carried out among abortion-related admissions in a tertiary care center from June 15 2018 to March 15, 2020. Ethical approval was taken from the institutional review committee (076/077/51). Data was collected using pre-designed proforma and analyzed in Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval (CI) was calculated along with frequency and proportion for binary data.
 Results: Out of 223 cases enrolled, 37 (16.6%) (9.6-23.6 at 95% Confidence Interval) were self-induced abortion cases by self-administration of abortion pills. The mean gestational age at the time of intake of pills was 7+6±3+1 week of gestation. The majority were diagnosed with incomplete abortion 14 (37.8%) followed by septic abortion 8 (21.6%). A surgical evacuation was performed in 25 (67.6%). Anemia was observed in 19 (51.3%) with severe anemia in 4 (10.8%). Blood transfusion was carried out in 14 (37.8%). Post abortive contraception was accepted by only 16 (42.3%).
 Conclusions: Medical abortion is safe if done under supervision but self-induced abortion by self-administration of abortion pills has a high complication rate. Therefore, further studies exploring a different dimension of the serious issue is the need of time.

Demography, clinical profile and outcomes of self-prescribed abortion pills among women, experience from a tertiary care teaching hospital in central India

“…Thapa et al reported, 37.8% were primigravida and 62.2% were multigravida. 11 This demonstrates that women rely on medical abortion and see it as a better way to space out their pregnancies than taking contraception and preventing undesired pregnancies in the first place. The safe upper gestational age limit for pill intake is seven weeks, according to the MTP Act of India.…”

Persistent gestational trophoblastic disease following ovarian molar pregnancy: A case report of a rare entity with review of the literature

“…Among women who had a self-induced abortion by self-medication, 13.5% had an ectopic pregnancy and among them, one was the case of ovarian molar pregnancy. 10 Standard treatment options for GTD differ depending on the implantation location and stage of the disease. Treatment includes chemotherapy, suction evacuation, hysterectomy, or a combination of all.…”

“…Also, about 23.5% of women with ectopic pregnancy had a history of consuming MA pills 9 but self‐medication with abortive medications complicating ovarian molar pregnancy is rare. Among women who had a self‐induced abortion by self‐medication, 13.5% had an ectopic pregnancy and among them, one was the case of ovarian molar pregnancy 10 …”

Factores de riesgo asociados al aborto incompleto en gestantes atendidas en el Hospital de Ventanilla, julio a diciembre del 2020

“…Examen de orina para cuantificar la diuresis y presencia de alguna infección asociada o descartar enfermedad renal. Pruebas de VDRL para descartar sífilis, Elisa para VIH y prueba para confirmar efectivamente un embarazo (cuantificación de la hormona coriónica humana subunidad beta) (31).…”