Background: Induced abortion is a major public health challenge worldwide particularly in developing country. It is one of the leading causes of maternal death.
Objective: To compare the early complications of induced abortion with those of spontaneous abortion in Yaoundé. Methodology: We conducted a cohort study from November 1st 2019 to May 31st, 2020 with prospective data collection in the gynecology departments of the Yaoundé Gyneco-Obstetric and Pediatric Hospital and the Yaoundé Central Hospital. All women who had an abortion and gave informed consent were included in our study. Data were analyzed using SPSS 23.0 and Microsoft Excel 2016. To compare the different observations, we used the Relative Risk (RR) as well as the Odds Ratio (OR) and the significance threshold was set at 5%. Results: Patients with induced abortion were significantly younger than those with spontaneous one (median age: 24 years [20-30] vs. 28 years [24-32]; p = 0.013). Clinically, fever was significantly more common in induced abortion group (28.6%) than in spontaneous one (6.8%). The rate of complication was higher in the induced abortion group. However, haemorrhage and anaemia were observed in both groups with no significant difference. Induced abortion increases the risk of sepsis by 4.48. Some complications were observed only in cases with induced abortion, namely uterine perforation (8.9%), pelviperitonitis (7.1%), septic shock (3.6%) and intestinal lesions (1.8%). In terms of management, induced abortion carries twice the risk of blood transfusion (p = 0.030). The overall post-abortion contraceptive use rate was only 40.9%. In terms of prognosis, the case-fatality rate was 3.6% among patients with induced abortion. Conclusion: Induced abortion, compared to spontaneous abortion, is the prerogative of adolescents. Abortion remains a major provider of maternal morbidity and mortality in our country, where the application of postabortion care remains partial. We recommend a full implementation these cares, with emphasis on family planning.
induced abortion; spontaneous abortion; miscarriage, infection, blood transfusion, contraception
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