Transient reduction in abortion‐related lethality after interventions to reduce delays in provision of care at Centre Hospitalier de Libreville, Gabon

Minkobame, Ulysse; Mayi-Tsonga, S.; Obiang, Pamphile Assoumou; Komba, Opheelia Makoyo; Ella, Justine M.; Meye, Jean‐François; Faúndes, Aníbal

doi:10.1002/ijgo.12586

Cited by 3 publications

(3 citation statements)

References 2 publications

(2 reference statements)

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“…It is a quick procedure that can be performed in outpatient clinics using less complex anesthetic procedures [8,13]. It has been emphasized that the replacement of uterine curettage by MVA reduces the mortality rate from 1.23-0.07% [24]. A systematic review that analyzed complications related to MVA showed that less than 5% of women experienced hemorrhage without blood transfusion, less than 0.1% presented with uterine perforation or bleeding requiring blood transfusion, less than 0.5% were hospitalized, and only 3% had repeated aspirations, with no maternal deaths reported [25].…”

Section: Discussionmentioning

confidence: 99%

Promoting evidence-based clinical practice for women in abortion situations after the implementation of a surveillance network: a situational analysis in a Brazilian university hospital

Veiga-Junior

Eugeni

Kajiura

et al. 2021

Preprint

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Background Manual vacuum aspiration (MVA) and medical abortion (MA) can be used to treat women with abortion complications and the choice of the evacuation method is essential for the safe management of abortion. Objective to evaluate the frequency of use of MVA and MA and investigate the associated factors after the installation of a surveillance network of good practices (MUSA Network) in a university hospital in Brazil. Methods A cross-sectional study of women admitted for abortion at UNICAMP Women’s Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the rates of MVA and MA. The independent variables were clinical and sociodemographic data. The Cochran-Armitage test, chi-square test, Mann–Whitney test and multiple logistic regression were used for statistical analysis. Results 474 women were included. Most women (91.35%) had undergone uterine evacuation: uterine curettage (78.75%), MVA (9.46%) and MA (11.54%). We observed a significant tendency toward an increase in the use of MVA (Z = 9.85; P <0.001). Factors independently associated with performance of MVA were admission in 2020 (OR 64.22; 95% CI 3.79–1086.69) and lower gestational age (OR 0.837; 95% CI 0.724–0.967). The only factor independently associated with MA was a higher level of education (OR 2.66; 95% CI 1.30-5.46). Conclusion the use of MVA increased after the installation of a surveillance network for good clinical practices. Being part of networks that encourage the use of evidence-based practices is an opportunity for health facilities to increase access to safe abortions.

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Section: Discussionmentioning

confidence: 99%

Promoting evidence-based clinical practice for women in abortion situations after the implementation of a surveillance network: a situational analysis in a Brazilian university hospital

Veiga-Junior

Eugeni

Kajiura

et al. 2021

Preprint

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“…Between 1989 and today. This has gone from endouterine curettage under general anesthesia to manual suction [16,18]. At the Libreville University in 2005, the proportion of manual suction carried out was 1.7%.…”

Section: Supportmentioning

confidence: 99%

“…At the Libreville University in 2005, the proportion of manual suction carried out was 1.7%. In 2016 it rose to 64.5% and in other countries which have adopted the IFGO initiative it also increased [18]. These figures are below those of Moussa Nouhoum in Ségou (97.1%) and Leke and Tumasang in Cameroon (100%) [7,12,19].…”

Section: Supportmentioning

confidence: 99%

Practice of Manual Intrauterine Aspiration for Post- Abortion Care (PAC): Prospective Study of 137 Cases at Owendo’s CHU Maternity Hospital

B¹,

Co²,

Obame³

et al. 2019

WJGWH

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According to the WHO, induced abortion today is one of the frequent complications of the first trimester of pregnancy and one of the pillars responsible for maternal deaths in low-income countries [1,2]. Worldwide, 20 million at-risk abortions and 80000 deaths per year are recorded or 1/8 deaths. Africa has 3.7 million and 23 miles of deaths as a result of these complications [3].Abortion is a public health problem that affects women of all ages, but especially young women who are less financially well off and less informed about family planning services. Moreover, these are most often advanced clinical forms and their management is often delayed [1]. This delay is multifactorial. In 2009, a series produced by Mayi-Tsonga and al. At the Libreville University Hospital showed that women died from unsafe abortions. These deaths were related to long delays in receiving emergency obstetric care (EOC) [4]. The authorities then supported the recommendations of the Hospital Committee on Maternal Mortality, which called for shortening delays and also improving the care of women suffering from abortion complications. This explains why the Gabonese Society of Obstetric Gynecology and Reproduction (GSOGR) have agreed to participate in the FIGO initiative for the prevention of unsafe abortions and their consequences [5]. For example, hospitals have introduced manual intra-uterine aspiration training (MIA) into health care provider. It is a method of uterine evacuation that mobilizes few means, accessible by all health formations and preserves fertility by avoiding immediate complications. It can be made using syringe

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Preventing unsafe abortion: Achievements and challenges of a global FIGO initiative

Faúndes¹,

Comendant²,

Dilbaz³

et al. 2020

Best Practice & Research Clinical Obstetrics & Gynaecol

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Transient reduction in abortion‐related lethality after interventions to reduce delays in provision of care at Centre Hospitalier de Libreville, Gabon

Abstract: Abortion‐related fatalities decreased from 12.3 per 1000 abortions to 0.7 per 1000 following an intervention at the Centre Hospitalier de Libreville, Gabon. After discontinuation of the intervention, fatalities reverted to previous levels.

Cited by 3 publications

References 2 publications

Promoting evidence-based clinical practice for women in abortion situations after the implementation of a surveillance network: a situational analysis in a Brazilian university hospital

Promoting evidence-based clinical practice for women in abortion situations after the implementation of a surveillance network: a situational analysis in a Brazilian university hospital

Practice of Manual Intrauterine Aspiration for Post- Abortion Care (PAC): Prospective Study of 137 Cases at Owendo’s CHU Maternity Hospital

Preventing unsafe abortion: Achievements and challenges of a global FIGO initiative

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