Naqvi Kaniz Zehra, Edhi Muhammad Muzzammil
Liaquat National Hospital and Medical Collage, 402, Al jannat plaza, M,A,Jinnah road, Karachi, Pakistan.
Patient Saf Surg. 2013 Oct 16;7(1):33. doi: 10.1186/1754-9493-7-33.
Every year 42 million women with unintended pregnancies choose abortion, and fifty percent of these procedures, 20 million are unsafe. An unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both.Pakistan is the one of the six countries where more than 50% of the world's all maternal deaths occur. It is estimated that 890,000 induced abortions are performed annually in Pakistan, and estimate an annual abortion rate of 29 per 1000 women aged 15-49.
Here we present a case report of a 29-year old woman who underwent an unsafe abortion for unintended pregnancy resulting in uterine perforation. The unskilled provider pulled out her bowel through vagina after perforating the uterus, as a result she lost major portion of her small intestine resulting in short bowel syndrome.
The law of Pakistan only allows abortion during early stages of pregnancy for purpose of saving the life of a mother but does not cater for cases of rape, incest and fetal abnormalities or social reasons.Only legalization of abortion is not sufficient, preventing unintended pregnancy should be the priority of all the nations and for this reason contraception should be widely accessible.Practitioners need to become better trained in safer abortion methods and be to able transfer the patient to health facility when complications occur.
每年有4200万意外怀孕的女性选择堕胎,其中50%,即2000万例堕胎是不安全的。不安全堕胎被定义为要么由缺乏必要技能的人员进行,要么在不符合最低医疗标准的环境中进行,或者两者皆有的终止意外怀孕的手术。巴基斯坦是全球孕产妇死亡人数超过50%的六个国家之一。据估计,巴基斯坦每年进行89万例人工流产,估计15至49岁女性的年堕胎率为每1000人中有29例。
在此,我们报告一例29岁女性的病例,她因意外怀孕接受了不安全堕胎,导致子宫穿孔。不熟练的施术者在子宫穿孔后经阴道拉出了她的肠子,结果她失去了大部分小肠,导致短肠综合征。
巴基斯坦法律仅允许在怀孕早期为挽救母亲生命而堕胎,但不涉及强奸、乱伦、胎儿异常或社会原因等情况。仅堕胎合法化是不够的,预防意外怀孕应是所有国家的首要任务,因此避孕措施应广泛可得。从业者需要接受更好的安全堕胎方法培训,并在出现并发症时能够将患者转诊至医疗机构。