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  • Title: [Abortion as a cause of maternal mortality].
    Author: Volgina VF, Gurtovoĭ BL.
    Journal: Akush Ginekol (Mosk); 1990 Oct; (10):11-5. PubMed ID: 2288349.
    Abstract:
    It has been shown that 65.8% of 343 women died in the second trimester and 69.6% after an illegal abortion. Sepsis and peritonitis were the main causes in the general population (73.9%) and in women who died from illegal abortions (88.6%). Defects in medical care were found. The medical documents of 342 women who died as a result of abortion (induced, self-induced, and outside of hospitals) were analyzed. 24.2% of the women were under 24 years of age, 51.3% were 25-34 years old, and the rest were 35 or older. 69.9% of the women died after abortion outside of hospitals and the rest after self-induced and induced abortions. 65.8% of the women were pregnant at 13-27 weeks of gestation. The death of 186 of 238 women was due to abortions performed outside of hospitals. Most of these were the result of invasive methods (the introduction of the catheter, solutions, rupture of the amniotic sac). These women subsequently received medical assistance. 93.3% of them were hospitalized with delay, and only 2.6% were admitted in satisfactory condition. In a significant proportion of patients the examination was belated and inadequate. Various laboratory hematological tests that were essential for diagnosis and determination of the severity of the process were not done. The bacteriological tests to select the appropriate antibacterial drug were rarely performed--the tests were done for only 19.8% of women who had died of sepsis and for 14.3% of those who had died of peritonitis. Inadequate care manifested itself in the fact that diagnosis was established for only 46.8% of patients. Sepsis and peritonitis were the cause of death for 73.9% of all women and for 88.6% of those who died of abortion outside the hospital. Hemorrhage was the second most frequent cause, with 42 women dying because of it. Other causes were anaphylactic shock and thromboembolism of the pulmonary arteries. The elimination of such causes of death mandate goal-oriented preventive measures accompanied by diagnosis and therapy and the raising of the knowledge level of the medical personnel about purulent-septic infections. A radical improvement in bacteriological care also must be effected.
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