PERFORATION OF UTERUS FOLLOWING A INDUCED ABORTION

Abstract

Septic induced abortion is a major public
health problem. An infected abortion
complicated by fever, endometritis, parametritis
and rupture uterus remains
one of the most serious threats to
womens health worldwide.Mortality and
morbidity from septic abortion are infrequent
in countries in which induced abortion
is legal.Septic abortion is a paradigm
of preventive medicine relating all levels
of prevention, primary, secondary and
tertiary1. A 25 years old patient 2ndgravida
was admitted in a septic ward in our
institute with complaints of Oliguria, abdominal
pain, vomiting following a dilatation
and curettage that had history of two
months amenorrhoea and ultrasound
finding of incomplete abortion. Patient
was initially treated with antibiotics later
suspected as rupture uterus and referred
to our institute for further management.
Keyword :perforation of uterus,septic
abortion,induced abortion.
Introduction:
The most important public health
effect of legalisation of abortion is near
elimination of death from illegal abortion.
Illegal abortion deaths are disproportionately
high due to infection. 62% of illegal
abortion deaths, 51% of spontaneous abortion
deaths were from infection, whereas
only 21% of legal abortion deaths were
from infection. With more advanced gestation
the risk of perforation and retained tissue
increases. Delay in treatment allows
progress to bacteraemia, pelvic abscess,
septic pelvic thrombophlebitis, disseminated
intra vascular coagulation, rupture
uterus, septic shock, renal failure and
death. The WHO estimates 68,000 deaths
from unsafe abortion every year constituting
13% of maternal deaths2