Factors associated with severity of early complications of abortion at Webuye district hospital in western Kenya

Abstract

Introduction: Complications of abortion are responsible for an estimated 21,000 admissions, to Kenya's public hospitals annually. This study was designed to determine the magnitude, and the clinical and sociodemographic factors associated with severity of early complications of abortion. Study design: Cross-sectional descriptive study Setting: Webuye District Hospital, Western Kenya Methodology: All women with a diagnosis of incomplete abortion and other abortion related complications, admitted to the gynecology ward of the Webuye District Hospital, within the twelve month study period, were consecutively enrolled into the study. Data collection was through administration of a standardized semi-structured questionnaire and chart review. Main outcome measures included temperature, blood pressure, pulse rate, pallor, evidence of foreign body, mechanical injury, offensive products of conception and other signs of infection/complication. Chi-square and t- tests and logistic regression models were employed in the statistical analysis of the data. All the analysis was performed in SPSS V.12.0 1. P-value of less than 0.05 was considered statistically significant. Results: A total of 149 cases of abortion were enrolled during the study period. The mean age was 26.5±7.6 years. More than half (55.7%) of the women had reached the second trimester of their pregnancy. Young women «20years old) accounted for 20.8% of the study sample. Young women (age<20years) were less likely to report contraceptive use at the time of conception (OR 0.11, 95%CI 0.03-0.41) than were adult women. Women with second trimester abortion complications were more likely to have signs of genital tract injury than those with first trimester abortion complications (OR 5.3, 95%CI 0.602-43.74) and had a 42% more chances of having offensive products of conception than those with first trimester abortion complications(OR 1.45, 95%CI 0.64- 3.27). Conclusion: There are disproportionately high numbers of women both young and old ending up with unwanted pregnancies, due to unmet need for family planning, with a majority presenting with 2 nd trimester abortion complications. The overall severity of abortion complications was not significantly affected by socio demographic characteristics of the women.