Melese Tadele, Habte Dereje, Tsima Billy M, Mogobe Keitshokile Dintle, Nassali Mercy N
Department of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana.
Consultant Public Health Specialist, Addis Ababa, Ethiopia.
PLoS One. 2018 Feb 16;13(2):e0192438. doi: 10.1371/journal.pone.0192438. eCollection 2018.
Post abortion complications are the third leading cause of maternal death after hemorrhage and hypertension in Botswana where abortion is not legalized. This study aimed at assessing the management of post abortion complications in Botswana.
A retrospective study was conducted at four hospitals in Botswana in 2014. Socio-demographic, patient management and outcomes data were extracted from patients' medical records. Descriptive statistics and chi-square test were used to analyze and present the data.
A total of 619 patients' medical records were reviewed. The duration of hospital stay prior to uterine evacuation ranged from less than an hour to 480 hours. All the patients received either prophylactic or therapeutic antibiotics. Use of parenteral antibiotics was significantly associated with severity of abortion, second trimester abortion, use of blood products and the interval between management's decision and uterine evacuation. Uterine evacuation for retained products of conception was achieved by metallic curettage among 516 (83.4%) patients and by vacuum aspiration in 18 (2.9%). At all the study sites, Misoprostol or Oxytocin were used concurrently with surgical evacuation of the uterus. None use of analgesics or anesthetics in the four hospitals ranged between 12.4% to 28.8%.
There is evidence of delayed patient care and prolonged hospital stay. Metallic curette was the primary method used for uterine evacuation across all the facilities. Pain management and antibiotics use was not standardized. A protocol has to be developed with the aim of standardizing post abortion care.
在博茨瓦纳，堕胎不合法，堕胎后并发症是孕产妇死亡的第三大主要原因，仅次于出血和高血压。本研究旨在评估博茨瓦纳堕胎后并发症的管理情况。
2014年在博茨瓦纳的四家医院进行了一项回顾性研究。从患者的病历中提取社会人口统计学、患者管理和结局数据。使用描述性统计和卡方检验来分析和呈现数据。
共审查了619例患者的病历。子宫排空术前的住院时间从不到1小时到480小时不等。所有患者均接受了预防性或治疗性抗生素治疗。静脉注射抗生素的使用与堕胎严重程度、孕中期堕胎、血液制品的使用以及管理决策与子宫排空之间的间隔时间显著相关。516例（83.4%）患者通过金属刮宫术实现了对残留妊娠产物的子宫排空，18例（2.9%）通过真空吸引术实现。在所有研究地点，米索前列醇或缩宫素与子宫手术排空同时使用。四家医院中未使用镇痛药或麻醉药的比例在12.4%至28.8%之间。
有证据表明患者护理延迟且住院时间延长。金属刮宫术是所有医疗机构用于子宫排空的主要方法。疼痛管理和抗生素使用不规范。必须制定一项协议，以规范堕胎后护理。
