Srinil Sukanya
Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand.
J Med Assoc Thai. 2011 Apr;94(4):408-14.
To assess factors associated with severe complications in unsafe abortion and to compare the complications in unsafe abortions with spontaneous or therapeutic induced abortion at Khon Kaen Hospital.
Four hundred sixty two medical records with the diagnosis of abortion at Khon Kaen Hospital between January and December 2008 were reviewed. Patient characteristics, complications and treatment outcomes were collected. The complications from abortion were classified into mild and severe group. Qualitative data were presented as frequencies and percentage. Comparison data was analyzed by using Pearson Chi-square test.
Out of 462 cases of abortion observed over the study period, 170 (36.8%) women had undergone an unsafe abortion. Twenty-seven (16%) women had severe complications and included 18 cases with hemorrhage requiring blood transfusions (66.6%), 17 cases with shock (63%), six cases with acute renal failure (22.2%), two cases with sepsis with DIC (7.4%) and two death cases. Ninety-five women (56%) in the unsafe abortion did not use any contraception. When compared between the mild and severe complication in the unsafe abortion group, there were statistical differences in the marital status, level of education and the method used (p = 0.003, p = 0.019, p < 0.001, respectively). Severe complications from unsafe abortion more frequently occurred in married, low educated women where intrauterine chemical injection was the most often used.
The unsafe abortion had more severe complications than the spontaneous or therapeutic abortion, which had affected the women's health. Level of education, marital status, and method used were factors associated with severe complications in unsafe abortion.
评估不安全流产严重并发症的相关因素,并比较孔敬医院不安全流产与自然流产或治疗性人工流产的并发症情况。
回顾了孔敬医院2008年1月至12月期间诊断为流产的462份病历。收集了患者特征、并发症及治疗结果。将流产并发症分为轻度和重度组。定性数据以频率和百分比表示。采用Pearson卡方检验分析比较数据。
在研究期间观察的462例流产病例中,170例(36.8%)妇女经历了不安全流产。27例(16%)妇女出现严重并发症,包括18例出血需输血(占66.6%)、17例休克(占63%)、6例急性肾衰竭(占22.2%)、2例败血症伴弥散性血管内凝血(占7.4%)以及2例死亡病例。95例(56%)不安全流产妇女未采取任何避孕措施。比较不安全流产组的轻度和重度并发症,婚姻状况、教育程度和所用方法存在统计学差异(分别为p = 0.003、p = 0.019、p < 0.001)。不安全流产的严重并发症在已婚、低学历且最常采用宫内化学注射方法的妇女中更频繁发生。
不安全流产比自然流产或治疗性流产有更严重的并发症,影响了妇女健康。教育程度、婚姻状况和所用方法是与不安全流产严重并发症相关的因素。