The Postabortion Caseload in Egyptian Hospitals: A Descriptive Study

Huntington, Dale; Nawar, L; Hassan, Ezzeldin Osman; Youssef, Hala; Abdel-Tawab, Nahla G.

doi:10.2307/2991916

Cited by 25 publications

(35 citation statements)

References 5 publications

(4 reference statements)

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“…24 The clinical criteria were later tested and adapted by researchers in South Africa who proposed using only women's symptoms, as observed by their providers, to categorise low, moderate and high severity complications (Table 1). 18 The methodology has been used to classify cases using a retrospective medical record review 10,11,25 and for prospective use by researchers in South Africa, [17][18][19][20][21][22] Kenya 23 and now in Cambodia. In South Africa, the study was conducted twice in a 4-year period to document changes in abortion-related morbidity due to legalisation of terminations in the country.…”

Section: Discussionmentioning

confidence: 99%

Abortion‐related complications in Cambodia

Fetters¹,

Saphonn

Picardo

et al. 2008

BJOG

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Introduction Although termination of pregnancy (termination) has been legal in the Kingdom of Cambodia since 1997, a number of barriers to safe termination services persist and many women continue to induce their own terminations or seek unsafe services that result in complications requiring 'post-abortion' care.Objective To describe the complications of miscarriage and failed terminations and document the magnitude of the resulting morbidity in the Cambodian public sector.Design Cross-sectional descriptive study.Setting Public sector hospitals and health centres.Sample Stratified multistage sampling design included all hospitals (n = 71), 14% of eligible high-level health centres (n = 58) and 22% of eligible low-level health centres (n = 57).Methods Data collectors used a standardised questionnaire to record information on diagnosis, reproductive history and treatment from 629 women seeking care for termination or miscarriage-related complications in study facilities over a 3-week period.Main outcome measures Annual estimate of cases, clinical symptoms, severity distribution of morbidity, ratio of complications to live births and incidence of abortion complications for Cambodian public health facilities.Results In 2005, an estimated 31 579 women with complications of miscarriage or terminations were treated in Cambodian government facilities; 80% of these women sought care at a health centre. Forty percent of all women seeking care for complications either reported or showed strong clinical evidence of prior attempted terminations. Nearly 17% of these women were in the second trimester of pregnancy and 42% of them presented with high severity complications. The annual incidence of termination and miscarriage complications (abortion complications) was 867 per 100 000 women of reproductive age. The projected ratio of complications was 93 per 1000 live births.Conclusions To reduce maternal morbidity in Cambodia, women must be encouraged to seek safe termination services or seek postabortion care without delay. Additionally, providers need further training, and facilities greater commitment, to provide safe terminations and care for complications of unsafe terminations and miscarriage.

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Section: Discussionmentioning

confidence: 99%

Abortion‐related complications in Cambodia

Fetters¹,

Saphonn

Picardo

et al. 2008

BJOG

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“…6 The technical and clinical interventions needed to provide safe, accessible and high quality abortion and menstrual regulation services are well known and include using vacuum aspiration or medication abortion instead of dilation and curettage for uterine evacuation; providing services in outpatient facilities, rather than in operating theaters; having midlevel providers instead of specialists provide care; and providing contraceptive counseling and services. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Each of these interventions has been shown to reduce the cost of care at the individual, facility or health system levels. 9,12,15,[17][18][19][20][21] Despite the advantages of these interventions in terms of safety and cost, they are often not implemented or are used inconsistently, preventing measurement of costs of services at facility or health system levels.…”

mentioning

confidence: 99%

Health System Costs of Menstrual Regulation and Care For Abortion Complications in Bangladesh

Johnston

Oliveras²,

Akhter³

et al. 2010

IPSRH

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Abortion-related mortality and morbidity result in significant health system costs. Approximately 42 million induced abortions occur around the world each year, 1 of which an estimated 22 million are conducted under unsafe conditions-that is, by an unqualified provider, in unsanitary conditions or both. 2 At least 65,000 women die annually from complications of unsafe abortion, and close to five million suffer temporary or permanent disability. 3 A recent analysis suggests that in Africa and Latin America, the annual cost of caring for women with complications of unsafe abortion ranges from US$159 million to US$333 million. 4 According to studies from a number of countries where the incidence of unsafe abortion is high, treatment of abortion complications can account for as much as 50% of hospital budgets for obstetrics and gynecology. 5 Abortion-related mortality and morbidity-and their associated health system costs-can largely be avoided through the prevention of unwanted pregnancy and through the provision of safe abortion services and menstrual regulation. 6 The technical and clinical interventions needed to provide safe, accessible and high quality abortion and menstrual regulation services are well known and include using vacuum aspiration or medication abortion instead of dilation and curettage for uterine evacuation; providing services in outpatient facilities, rather than in operating theaters; having midlevel providers instead of specialists provide care; and providing contraceptive counseling and services. 7-21 Each of these interventions has been shown to reduce the cost of care at the individual, facility or health system levels. 9,12,15,[17][18][19][20][21] Despite the advantages of these interventions in terms of safety and cost, they are often not implemented or are used inconsistently, preventing measurement of costs of services at facility or health system levels.Savings-an abortion-oriented costing spreadsheet-was developed by Ipas to generate estimates of the costs of different strategies of providing abortion care. The initial application of the Savings model used published data primarily from Uganda; 22 however, because the abortion law in Uganda is restrictive, some data from other African countries were used to project costs of providing safe and legal abortion-related care. Results suggest that use of recommended technical interventions would substantially reduce costs of providing abortion care.In Bangladesh, the abortion law is also restrictive; however, menstrual regulation-defined as the evacuation of the uterus of a woman at risk of being pregnant to ensure a state of nonpregnancy-is provided by the government as a backup to contraception for women up to 10 weeks from the beginning of their last menstrual period. The procedure is sanctioned by the government and available at all levels of the public health care system. The Bangladesh menstrual regulation program has had many of the recommended best practices for abortion- Health System Costs of Menstrual Regulation and Care For Ab...

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“…This indicator is highly correlated with maternal mortality levels, although such a correlation does not provide levels of causality (6).…”

Section: Usementioning

confidence: 93%

“…Where estimates can be reliably produced at a subnational level, these may help to set priorities. For example, a ratio of 50-250 per 100 000 may point to problems of quality of care for labour/delivery, while higher ratios (>250) may suggest problems of access as well (6).…”

Section: Usementioning

confidence: 99%

Current state of cryopreservation of reproductive cells and embryos

Petrushkо¹

2017

Visn. Nac. Akad. Nauk Ukr.

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The Postabortion Caseload in Egyptian Hospitals: A Descriptive Study

Cited by 25 publications

References 5 publications

Abortion‐related complications in Cambodia

Abortion‐related complications in Cambodia

Health System Costs of Menstrual Regulation and Care For Abortion Complications in Bangladesh

Current state of cryopreservation of reproductive cells and embryos

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