Septic abortion leading to intestinal perforation: 4 case reports with Review of literature

Abstract

Abortion is considered taboo In our society so it is unreasonable to expect reliable data about abortion practices , especially in India more so in rural areas . Most of illegal abortions are conducted in rural areas of developing countries without adequate facilities and person with no knowledge of anatomy who operate with non sterile instruments which further add to morbidity and mortality. As per the world Health Organization (WHO) estimate for 2000, about 19 million unsafe abortions performed worldwide resulting in death of 70000 women. Uterine perforation during abortion is rare, with incidence of 0.05-0.4 % but up to 3.6 % in undeveloped counties. One rare complication following surgical abortion is bowel perforation , small bowel is most commonly perforated due to central pelvic location, length and mobility . Illegal abortion are performed especially in unmarried females with secrecy. These abortions are performed at clinics run by quacks, dais and nurses with little knowledge of procedures and its outcomes, most of patients belong to low socioeconomic status and delayed referral mostly contribute to increased morbidity and mortality . Here we are presenting 4 cases which presented to our emergency ( Rural Tertiary care center BPS GMC Khanpur kalan) over a period of 3 months with perforation peritonitis after unsafe abortion.