DEFINITION

Abortion is termed the termination of

pregnancy before the period of fetal
viability usually taken in our environment
to be the 28th week of gestation.
Or
By WHO; The expulsion or extraction
from it’s mother of a fetus weighing
500gm or less.
Modern Methods of Abortion
Medical
– First trimester
Antiprogestogens, Mifepristone(Ru486)600mg
+prostaglandin-misoprostol
Methotraxate+ Misoprostol
– Second trimester
2/3 of complications
50% of Deaths
Hyper tonic saline or urea-intra/extra amniotic
Prostaglandin E2,E1 or F2 alpha
(Vaginally or Intra amniotic)
SURGICAL
– Suction Curettage (MVA)
– Surgical Curettage (D&C)
– Dilatation & Evacuation
– Hysterotomy & Hysterectomy
– Menstrual Regulation
COMPLICATIONS OF ABORTION
Haemorrhage
Infection
Trauma-
– Perforation
– Cervical incompetence
– Uterine synechiae
Psychological Effects
Effect on Hospital Services
 Burden of the problem

 26-53 million induced abortion annually

 40% in countries with restrictive laws
 In Nigeria,
Abortion rates 25 per 1000 women ,
610,000 abortion per year.
40 % of maternal deaths
 Netherlands – 5 per 1000 women.
 PREDISPOSING FACTORS TO
UNSAFE ABORTION
Lack of adequate legislature and policies to regulate the
procedure.
Financial constraints on the part of the affected persons:
-to raise children
-to seek adequate contraception
-Acquire appropriate education
-Seek procedure under safe conditions
-medical care for treatment of complications.
Low illiteracy levels
Unstable family set up
Societal outlook and taboos
Single parenthood
Student pregnancies
Religious condemnation of pregnancies etc
Lack of information about complication of procedure,
preventive measures prevalence of unsafe abortions.
 Complications
EARLY LATE
-septic abortion -Chronic pelvic inflammatory
disease
-septic shock
-pelvic adhesions
-Injury
-chronic tubo-ovarian masses
-chronic pelvic pain
-vagina, cervix, uterus
-tubal occlusion
-perforation of large /small
bowels Ectopic Gestation
-Acute renal failure Infertility
-Dissseminated intravascular Asherman’s syndrome
coagulation -infertility
-Incomplete abortion -oligomenorrhoea
-Haemorrhage /amenorrhoea
-pelvic abscesses -intrauterine adhensions
-septic pelvic thrombophlebitis
-Septic arthritis Psychological factors
-Tetanus -grief
Adult respiratory distress -regrets
syndrome -dejection