Postabortion case load study in Egyptian public sector hospitals : final report

Key findings include the following. (1) About 28,000 women present themselves for postabortion treatment in Egyptian public sector hospitals each month, or about 336,000 per annum. Only about a third of these consist of spontaneous miscarriages. (2) Overall mean age of the patients is 27.43 years, and the mean number of previous pregnancies is 3.22. About 37% report a previous miscarriage. (3) About 47% report having ever having used a contraceptive. This is less than the 68% of ever use among ever-married women and 70% of currently married women reported in the 1995 Egyptian Demographic and Health Survey. The mean gestational period of the aborted fetus is 10.79 weeks, with 86% of respondents reporting a gestational age of 12 weeks or less. (4) Dilatation and curettage (D&C) is the principal surgical technique used in the treatment of incomplete abortions in Egypt. Only 3% of the 4,071 patients who had some type of surgical procedure were treated with manual vacuum aspiration. Almost all (89%) received general anesthesia. (5) While the overall number of maternal fatalities is low (0.43 per 100 admissions), the fatalities seem to cluster in a few hospitals. The study concludes with a number of recommendations, chief among which is the critical need to upgrade the quality of the surgical materials available to physicians treating post-abortion patients. Routine procurement and distribution of manual vacuum aspiration instruments is strongly urged. Also recommended is the need for linkages between postabortion care and family planning services. (Author abstract, modified)