Department of Public Health and Nursing, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway.
Queen Elizabeth Central Hospital, Blantyre, Malawi.
Int J Environ Res Public Health. 2018 Feb 21;15(2):370. doi: 10.3390/ijerph15020370.
Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7-12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health.
马拉维的孕产妇死亡率很高，其中不安全堕胎是一个主要原因。尽管存在限制堕胎的法律，但据估计每年约有 14 万例人工流产。这导致了并发症的发生，如不完全流产，需要进行治疗以避免进一步的伤害。虽然手动真空抽吸（MVA）是一种安全且廉价的排空子宫的方法，但在马拉维最常用的方法是刮宫。该国很少使用医疗手段，卫生部一直在努力增加 MVA 的使用。本研究旨在调查马拉维南部三家公立医院在三年内治疗不完全流产的情况。对 2013 年至 2015 年女性/妇科病房的所有病历进行了回顾。总共从 7270 名接受不完全流产治疗的妇女中收集了产科史、人口统计学和治疗信息。在研究期间，三家医院 MVA 的总体使用率为 11.4%（95%CI，10.7-12.1）。然而，在一家地区医院，MVA 的应用有了很大的增加。为什么在这项研究中只有一家成功的医院尚不清楚，但可能是由于该特定医院进行了更多的培训和专门的领导。无论如何，尽管世界卫生组织（WHO）和马拉维卫生部提出了建议，但在马拉维，MVA 在治疗不完全流产中的使用仍然很低。
