Factors associated with severe complications in unsafe abortion.

OBJECTIVE: To assess factors associated with severe complications in unsafe abortion and to compare the complications in unsafe abortions with spontaneous or therapeutic induced abortion at Khon Kaen Hospital. MATERIAL AND
METHOD: Four hundred sixty two medical records with the diagnosis of abortion at Khon Kaen Hospital between January and December 2008 were reviewed. Patient characteristics, complications and treatment outcomes were collected. The complications from abortion were classified into mild and severe group. Qualitative data were presented as frequencies and percentage. Comparison data was analyzed by using Pearson Chi-square test.
RESULTS: Out of 462 cases of abortion observed over the study period, 170 (36.8%) women had undergone an unsafe abortion. Twenty-seven (16%) women had severe complications and included 18 cases with hemorrhage requiring blood transfusions (66.6%), 17 cases with shock (63%), six cases with acute renal failure (22.2%), two cases with sepsis with DIC (7.4%) and two death cases. Ninety-five women (56%) in the unsafe abortion did not use any contraception. When compared between the mild and severe complication in the unsafe abortion group, there were statistical differences in the marital status, level of education and the method used (p = 0.003, p = 0.019, p < 0.001, respectively). Severe complications from unsafe abortion more frequently occurred in married, low educated women where intrauterine chemical injection was the most often used.
CONCLUSION: The unsafe abortion had more severe complications than the spontaneous or therapeutic abortion, which had affected the women's health. Level of education, marital status, and method used were factors associated with severe complications in unsafe abortion.