Morbidity and mortality following induced abortion in Nnewi, Nigeria

We present a study of the maternal morbidity and mortality among 76 patients treated at the Nnamdi Azikiwe UniversityTeaching Hospital, Nnewi for complications of induced abortion from January 1996 to December 2000. The total number of maternal admissions over this period was 5750, and illegal induced abortion was responsible for 1.3% of the admissions, with a mortality rate of 5.3% (n=4) for induced abortion. This accounted for 21.1% of the total maternal deaths (n=19) for the period. The mean age of the women was 20.6 years (range 15-34 years), 94.7% (n=72) were unmarried, 93.5% (n=71) were nulliparous and 76.5% (n=58) were unemployed, 67.1% (n=51) had had a mid-trimester termination at >13 weeks gestational age. It is significant that 55.3% of the patients were teenagers and 45.1% of the mid-trimester abortions occurred in this group. Genital sepsis, haemorrhage, pelvic infection with peritonitis and abscess formation, uterine perforation, and gut injury were the major complications encountered. This study demonstrates that induced abortion is still a major cause of maternal mortality in Nigeria. Integrated family health education, planned parenthood and contraceptive education, a mass literacy campaign and improvement of the existing national health services are recommended in order to ameliorate the problems of illegally induced abortion in Nigeria.