Analysis of induced abortion-related complications admitted to referral based medical facilities in Kinshasa, Democratic Republic of the Congo.
Daniel Ishoso Katuashi1, Antoinette Tshefu Kitoto2, Yves Coppierters3
1Kinshasa School of Public Health, Lemba, Kinshasa, The Democratic Congo, 2Kinshasa School of Public Health, Lemba, Kinshasa, The Democratic Congo, 3Université libre de Bruxelles, Bruxelles, Belgium
Objectives: This study aims to analyse the extent of induced abortion-related complications at referral health facilities in Kinshasa and their characteristics, the length of hospitalisation, the proportion of deaths and their characteristics, as well as deaths that occurred after two days of hospitalisation.
Methods: The cross-sectional study focused on 1541 gynaecological patients admitted as emergencies at 7 referral health facilities in Kinshasa, from 1 January to 31 December 2014, facilities that were selected representatively from the 5 types of districts of Kinshasa. Information was collected by reviewing patient files/records and analysed with SPSS20 and Epi-Info3.5.4.
Results: There were 12.8% (11.2% to 14.6%) cases of induced abortion-related complications with a correlation to adolescence, celibacy, nulliparity, residence in semi-rural districts of Kinshasa and history of one or more abortions; 4.0% of deaths, including more than one third (1.8% to 4.0%) that are related to induced abortion-related complications, with a mortality of 13.6% and a significant increase in risk of death in the presence of a post abortive, pelvic peritonitis type complication. Half of these deaths occurred after two days of hospitalisation. Finally, the median length of hospitalisation was 10 days, higher in post abortive, pelvic peritonitis compared with patients with pelvic peritonitis due to Caesarean section/hysterectomy.
Conclusion: This study demonstrates that induced abortion-related complications were a significant public health problem, because of their frequency in cases admitted as gynaecological emergencies at referral medical facilities in Kinshasa and their weight on hospital maternal deaths, and, furthermore, that supportive care in hospitals poses a serious problem. Accordingly, there is a need to understand the reason for the problem of hospital care in order to fulfil and provide a set of services that is appropriate for those medical facilities.