Misoprostol and induced abortion in accra, ghana

MISOPROSTOL AND INDUCED ABORTION IN ACCRA, GHANA Maya, Ernest Tei1; Mumuni, Kareem2; Samba, Ali 2; Organizations: 1: Ridge Regional Hospital, Accra , Ghana; 2: Korle-bu Teaching Hospital, Accra, Ghana; 3: School of Public Health UG, Accra, Ghana • Unsafe abortion contributes significantly towards maternal morbidity and mortality in Ghana • Autopsy reports have revealed that abortion related causes are the leading cause of maternal • Misoprostol is seen as an important medication in obstetric practice and making it easily available for use is seen as one of the most important measures to reduce maternal mortality in sub- • Misoprostol however has been blamed for the increase in global incidence of unsafe abortion because of its low cost, convenience of use and lesser traumatic consequences • The abortion law in Ghana is less restrictive and safe abortion is provided in some public health institutions • However, self induced abortion is common and anecdotal information indicates that the availability of misoprostol is mostly responsible for this • This study aims to determine the proportion of women presenting with incomplete abortion who have induced abortion, proportion who used misoprostol, sources of misoprostol and what information is given to these women • A cross-sectional survey was undertaken consecutively enrolled women presenting with incomplete abortion for MVA at the Ridge Regional Hospital from 1st July 2010 to 30th August 2010 characteristics, contraceptive practices at the time of the pregnancy, whether abortion was spontaneous or induced, type and source of abortifacients, route • Descriptive statistics were estimated using • Bivariate analysis was performed using Chi- square tests and Student’s t tests (with significance level at 0.05). – 35% (48) reported having had induced abortion – Mean age of all respondents = 26.8yrs (SD 6.1) – Mean age spontaneous abortion= 28.7yrs (SD 6.1) – Mean age induced abortion = 23.4yrs (S.D 4.4) – Mean age misoprostol = 22.3yrs (S.D 4.4) – 41% nulliparous – Gestational ages of the pregnancies : 1 - 6 months • Of the 48 cases, 95.8% had procured the abortifacients by themselves /by others and self induced the abortion • 4.2% had either a D&C or intramuscular • 91.7% (44) reported they did not want the pregnancy out of which 84.1% were not on contraception at the time of the pregnancy Abortifacients/proced
Frequency
Percentage
• Drug stores/pharmacies supplied 97.4% of • No. of tablets used: 2 to 8 (median - 4) induced abortion was significantly associated with misoprostol use (p< 0.001) • Both the oral and rectal routes were used by • Only 5.3% (2/38) were told to expect some • No other information about the abortion process and where to seek help if need be was given • About a third of cases with incomplete abortion presenting for MVA had induced abortion • Self induced abortion is very high among • Misoprostol reportedly is the commonest abortifacient used by patients with induced abortion • Drug stores/pharmacies are the major • Virtually no information on the abortion process, side effects of misoprostol and where to seek treatment in case of complications was given to clients • There is the need for the health authorities to educate the populace on the benefits of contraceptive use, dangers of unsafe abortion and therefore the need to use safe abortion services when induced abortion is desired

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