Measham A R, Obaidullah M, Rosenberg M J, Rochat R W, Khan A R, Jabeen S
Lancet. 1981 Jan 24;1(8213):199-202. doi: 10.1016/s0140-6736(81)90070-2.
Health-workers in 795 health centres in Bangladesh were interviewed about complications arising from induced abortion in rural Bangladesh. 1590 cases of complications from abortion were reported. Dais (traditional birth attendants) and traditional practitioners were the larger groups of operators (42.1% and 18.1%, respectively). Menstrual regulation or dilatation and curettage (the medically approved procedures) were used 9.1% of the time. Nearly half the complicated abortions were induced by inserting a foreign object, such as a stick or root (sometimes treated with an herb), into the uterus and leaving it until either abortion or complications ensued. 498 abortion-related deaths were reported. The proportion of complicated abortions resulting in death was lowest for medically approved procedures (4.9%) and highest for vigorous physical activity (100%) and abdominal pressure (66.7%), although the last two together accounted for only 2.3% of abortion procedures. Women who died after abortion were more likely than were women who survived to be further along in their pregnancies. An extrapolation from these results gives a figure of 780000 abortions in Bangladesh in 1978 and 7800 deaths that year from abortion complications. Many of these deaths might have been prevented if a means of safe, affordable termination of unwanted pregnancy had been available.
对孟加拉国795个医疗中心的医护人员进行了访谈，了解孟加拉国农村地区人工流产引发的并发症情况。共报告了1590例流产并发症病例。接生婆（传统助产士）和传统行医者是实施手术的主要群体（分别占42.1%和18.1%）。采用月经调节术或刮宫术（医学认可的手术）的比例为9.1%。近一半的复杂流产是通过向子宫内插入异物（如木棍或树根，有时用草药处理），并留置在子宫内直至流产或引发并发症。报告了498例与流产相关的死亡病例。医学认可的手术导致复杂流产后死亡的比例最低（4.9%），剧烈体力活动导致的比例最高（100%），腹部施压导致的比例为66.7%，不过后两者导致的流产手术仅占2.3%。流产后死亡的女性比存活女性更有可能怀孕周数更大。根据这些结果推断，1978年孟加拉国有78万例人工流产，当年有7800人死于流产并发症。如果当时有安全、可负担得起的终止意外怀孕的方法，许多此类死亡本可避免。
