Unsafe abortion in lagos, Nigeria: a continuing tragedy.

OBJECTIVES: To assess the incidence, pattern of presentation and management of complications resulting from unsafe abortion as well as the associated demographic variables at the Lagos Island Maternity Hospital. PATIENTS AND METHODS: A cross sectional survey of all cases with complicated induced abortion was carried out between 1st August 2005 and 31st January 2007. RESULTS: The majority of the patients were young 21.7% were teenagers between 14 and 19 years while 32.6% were in the 20-24 year age group. The majority (64.0%) were single while 30.9% were married, 1.7% were divorced, while 3.4% were separated. Teenagers and single women were more likely to obtain their abortion late (above 12 weeks gestation). 81.2% of the patients knew about modern methods of contraception but only 34.5% had ever used contraception and only 8.6% were using contraception when they became pregnant. Medical doctors were the abortionists in 46.9% of the cases, followed by nurses (17.7%) and traditional practitioners. Retained products of conception was the commonest complication (77.1%) followed by anaemia (48.6%) and sepsis (44.6%). Evacuation of the uterus was the commonest surgical procedure done. There were 16 maternal deaths giving a case fatality rate of 9.14%. Sepsis was the commonest cause of death. CONCLUSION: Unsafe abortion remains a serious concern to the health of women. Efforts need to be maximised at preventing unwanted pregnancy by making contraceptive services easily accessible to women. Effective post abortion care services need to be put in place.