Septic abortion

developed countries; it is closely linked to environmental and socioeconomic conditions. Surgery and Background. The aetiological spectrum of acute renal failure (ARF ) has changed in developed countries. It trauma are the most common causes of ARF in developed countries . Recently, the incidence of was the purpose of the study to evaluate whether similar changes have occurred in this part of the world surgical and post-traumatic ARF has decreased, whereas that of medical ARF has increased. ARF due as well. Methods. In a prospective study a total of 439 patients to septic abortion or obstetric complications has almost disappeared in developed countries, but remains signi-with ARF were evaluated. They had been admitted to one hospital during two successive periods, i.e. ficant in developing countries . In Turkey, obstetric complications and septic abortion were the most 1983-1990 and 1991-1997. Results. Of 439 patients with ARF, 116 were admitted common causes of ARF in the 1970s . The aim of this study was to assess the aetiologies in 1983-1990 (first period) and 323 in 1991-1997 (second period). The age of presentation increased and outcomes, and their trends with time, of ARF in Central Anatolia ( Turkey). from 49.8±6.2 years in the first period to 58.8±16.4 years in the second. Medical causes were present in 259 cases (59%), surgical causes in 110 cases (25%), and obstetric causes in 70 cases (16%). The frequency Subjects and methods of surgical cases decreased from 28.4% in the first period to 23.8% in the second period. The respective Four hundred and thirty-three patients with ARF were figures for obstetric cases were 18.9% and 14.8%. admitted to the Nephrology Department of Erciyes Mortality did not change with time (33.6% in the first University Medical Faculty Hospital between 1983 and 1997 and 31.0% in the second period); the overall mortality in Turkey. The patient population was from the city of was 31.7%. The mortality was higher for surgical Kayseri and other cities of Central Anatolia including urban (45.5%) than for obstetric (27.8%) and medical ARF and rural areas. The total population was approximately (24.3%). 2 000 000 in which 800 000 of the people were living in the Conclusion. In the mid-1970s, the most common causes urban areas. Aetiologies and outcomes were compared in of ARF in Turkey were obstetric complications and the two successive periods, i.e. 1983-1990 (first period) and 1991-1997 (second period ). ARF was defined as an acute septic abortion. The aetiological spectrum of ARF has reduction of renal function, i.e. rise in serum creatinine levels changed and today medical causes predominate. ARF to >2 mg/dl despite absence or correction of prerenal causes resulting from septic abortion has become rare, pos- . Patients were classified as oliguric ( less than 400 ml sibly because of liberalization of abortion in 1983 urine/24 h) or non-oliguric (more than 400 ml urine/24 h). in Turkey. The diagnosis was based on history, physical examination, laboratory values, and clinical course. All patients were

developed countries; it is closely linked to environmental and socioeconomic conditions. Surgery and Background. The aetiological spectrum of acute renal failure (ARF ) has changed in developed countries. It trauma are the most common causes of ARF in developed countries . Recently, the incidence of was the purpose of the study to evaluate whether similar changes have occurred in this part of the world surgical and post-traumatic ARF has decreased, whereas that of medical ARF has increased. ARF due as well. Methods. In a prospective study a total of 439 patients to septic abortion or obstetric complications has almost disappeared in developed countries, but remains signi-with ARF were evaluated. They had been admitted to one hospital during two successive periods, i.e. ficant in developing countries . In Turkey, obstetric complications and septic abortion were the most 1983-1990 and 1991-1997. Results. Of 439 patients with ARF, 116 were admitted common causes of ARF in the 1970s . The aim of this study was to assess the aetiologies in 1983-1990 (first period) and 323 in 1991-1997 (second period). The age of presentation increased and outcomes, and their trends with time, of ARF in Central Anatolia ( Turkey). from 49.8±6.2 years in the first period to 58.8±16.4 years in the second. Medical causes were present in 259 cases (59%), surgical causes in 110 cases (25%), and obstetric causes in 70 cases (16%). The frequency Subjects and methods of surgical cases decreased from 28.4% in the first period to 23.8% in the second period. The respective Four hundred and thirty-three patients with ARF were figures for obstetric cases were 18.9% and 14.8%. admitted to the Nephrology Department of Erciyes Mortality did not change with time (33.6% in the first University Medical Faculty Hospital between 1983 and 1997 and 31.0% in the second period); the overall mortality in Turkey. The patient population was from the city of was 31.7%. The mortality was higher for surgical Kayseri and other cities of Central Anatolia including urban (45.5%) than for obstetric (27.8%) and medical ARF and rural areas. The total population was approximately (24.3%). 2 000 000 in which 800 000 of the people were living in the Conclusion. In the mid-1970s, the most common causes urban areas. Aetiologies and outcomes were compared in of ARF in Turkey were obstetric complications and the two successive periods, i.e. 1983-1990 (first period) and 1991-1997 (second period ). ARF was defined as an acute septic abortion. The aetiological spectrum of ARF has reduction of renal function, i.e. rise in serum creatinine levels changed and today medical causes predominate. ARF to >2 mg/dl despite absence or correction of prerenal causes resulting from septic abortion has become rare, pos- . Patients were classified as oliguric ( less than 400 ml sibly because of liberalization of abortion in 1983 urine/24 h) or non-oliguric (more than 400 ml urine/24 h). in Turkey. The diagnosis was based on history, physical examination, laboratory values, and clinical course. All patients were

PATIENTS AND METHODS: Medical records of patients with complications of termination of pregnancy were analyzed retrospectively. All patients with history of induced abortion who presented within 40 days of termination of unwanted pregnancy were included in study. Patients with habitual or spontaneous abortion or who were admitted after 40 days of induced abortion were excluded. RESULTS: During study period, total admissions in this unit were 3015. Among these, 498 patients presented with different types of abortion. Of these 498 patients, 32(6.42%) presented with history of complication of induced abortion and were included in study. Among these cases, 21(65.6%) patients were in age group 20-40 years; 9(28.12%) below 20 years and 2 (6.25%) above 40 years. Nine (28.12%) patients were primigravidae, 4(12.5%) multipara while 19 (59.37%) were grand multipara. Twenty-four (75%) patients were admitted with sepsis, 5(15.62%) with visceral injury and 3(9.37%) with haemorrhage. Ten (31.25%) patients underwent hysterectomy due to septic perforated uterus while 7(21.87%) patients expired due to complications of induced abortion. CONCLUSION: Induced abortion for termination of unwanted pregnancy is a major cause of maternal morbidity and mortality in our set up.

The study focuses on the macroscopic and microscopic aspects of the placentae resulting from abortions or febrile births and their correlation with acute disorders of the upper or lower respiratory apparatus in pregnant women in various stages of pregnancy. The viral, bacterial or mycotic disorders were considered responsible for triggering septic abortion, premature or full-term deliveries, followed by septic complications of the child/fetus or of the mother. When the mother's acute respiratory infection is induced by highly virulent pathogens, in patients with low immunity or lacking adequate medical treatment, the infection may spread through the mother's bloodstream to the placenta. The study was conducted on 90 placentae. Microscopic analysis of the tissue samples revealed acute inflammatory infiltration. Two of the study cases should be mentioned here: a four-month pregnant woman suffering from septic abortion and a nine-month pregnant woman whose fetus died in the wom...

To assess the feasibility of establishing a simple maternal morbidity surveillance system in Assam (Indian Obstetric Surveillance System-Assam (IndOSS-Assam)) to investigate the incidence and trends in severe maternal complications. This study presents the surveillance platform of IndOSS-Assam. Four tasks were undertaken: (1) setting up of a steering committee; (2) establishing priorities for the region; (3) mapping of surveillance sites; (4) piloting case-notification systems in selected centres. Two government tertiary hospitals in the state. Pregnant women delivering in the hospitals between March and August 2015. Incidence and case fatality rates with 95% CIs. Local stakeholder ownership and a simple uncomplicated anonymous system for case notification were the key strengths of this project. Cases and deaths were reported for six conditions: eclampsia, postpartum haemorrhage, puerperal sepsis, septic abortion, uterine rupture and anaemic heart failure. Among 10 475 women deliver...

To assess the feasibility of establishing a simple maternal morbidity surveillance system in Assam (Indian Obstetric Surveillance System-Assam (IndOSS-Assam)) to investigate the incidence and trends in severe maternal complications. This study presents the surveillance platform of IndOSS-Assam. Four tasks were undertaken: (1) setting up of a steering committee; (2) establishing priorities for the region; (3) mapping of surveillance sites; (4) piloting case-notification systems in selected centres. Two government tertiary hospitals in the state. Pregnant women delivering in the hospitals between March and August 2015. Incidence and case fatality rates with 95% CIs. Local stakeholder ownership and a simple uncomplicated anonymous system for case notification were the key strengths of this project. Cases and deaths were reported for six conditions: eclampsia, postpartum haemorrhage, puerperal sepsis, septic abortion, uterine rupture and anaemic heart failure. Among 10 475 women deliver...

A half million women die yearly around the world as a result of pregnancy. Many of these deaths are inaccurately classified and many others are not reported at all, but new demographic techniques have clarified causes of maternal mortality and improved estimates of rates. New data from several less developed countries suggest that many maternal deaths could be prevented by measures already demonstrated to be effective elsewhere. These include better antenatal and in trapartum care, contraception for women who want no more pregnancies, legal abortion to terminate unwanted pregnancies, and uterine aspiration and antibiotics for treatment of septic abortion.

Background: Abortion, even when provided by law in cases of sexual violence, continues to be practiced in an insecure way, since women who suffer violence are not reported or guarded by social, institutional or age vulnerability, as in adolescence. Objective: Describe the clinical consequences of unsafe abortion, report this experience as well as sexual violence in situations of social and age vulnerability. Method: It is a clinical case report, with the consent of the patient, in the year 2016, of a 16-year-old female adolescent with a personal history of sexual violence by an intimate aggressor. Admitted to the health service with diagnosis of acute abdomen and induced abortion using antibiotic therapy. Results: Laboratory tests revealed altered C reactive protein and presence of leukocytosis, ultrasound showed heterogenic mass, computed tomography showed presence of cylindrical foreign body in vaginal cavity, surgical interventions, sepsis, clinical complications (pulmonary throm...

Background: Acute kidney injury occurring during pregnancy, labour, delivery, and/or postpartum period. Proper management of AKI (acute kidney injury) is challenging because (i) both maternal and fetal health must be considered and (ii) the cardiovascular and renal adaptations of pregnancy add to the complexity for management. Methods: The objective of this study was to study association and contributing factors in AKI, a retrospective study of 20 cases of AKI complicating pregnancies carried out in department of obstetrics and gynecology, SVPIMSR over a period of 12 months and results were studied and analysed. Etiological factors, associated liver pathology, coagulation abnormality, thrombocytopenia, sepsis, recovery status and fetomaternal outcome were studied and tabulated. AKI was analysed in terms of maximal stage of renal injury attained as per risk, injury, failure, loss of function, and end-stage renal disease (RIFLE) criteria. Results: The incidence of ARF (acute renal failure) in pregnancy was about 0.3%. Hypertensive disorders were the major causative factor. Amongst the 20 cases, 8 cases were referred from outside and two of them died. Total 5 of 20 cases required hemodialysis and two of them had partial recovery. Conclusions: AKI complicating pregnancies are not uncommon. If recognized and treated promptly, recovery is assured in majority of cases. Early identification and prompt management of pre-eclampsia and sepsis can prevent majority of cases. Ultrasonography revelation of placenta previa or abruption helps in early management eventually decreases the chances of bleeding which is one of the causes of AKI (pre-renal cause).

Introducción: la mortalidad materna es un indicador básico de salud y refleja el estado de salud de un país. según la OMs alrededor de 1.500 mujeres muere al día por complicaciones del embarazo y el parto; 99% de estos casos ocurre en países del tercer mundo. Objetivo: determinar la tendencia y los características asociadas con la mortalidad materna en cali en el quinquenio 2005-2010. Metodología: se realizó un estudio descriptivo retrospectivo de las defunciones maternas ocurridas entre el 1 de enero del 2005 al 31 de diciembre del 2010, analizando los datos aportados por la secretaria Municipal de salud de cali, en los cuales se incluyeron las características de estos fallecimientos, sus causas directas e indirectas y los retrasos que se presentaron en cada caso. Resultados: la razón de mortalidad materna promedio fue 60 fallecimientos por cada 100.000 nacidos vivos; 97% de casos proceden del área urbana y 70% a los estratos 1 y 2; 72% requirieron cuidados intensivos. las 5 primeras causas directas de muerte fueron choque séptico y falla orgánica múltiple (17%), insuficiencia respiratoria y choque hipovolémico (8%) respectivamente y síndrome de distress respiratorio del adulto (7%). como causas básicas están preeclampsia y aborto séptico (9%) cada una, neumonía (7%), tromboembolismo pulmonar y hemorragia postparto (4%) respectivamente. Conclusión: la tendencia de la mortalidad materna en el quinquenio 2005-2010 presentó un comportamiento hacia la mejoría, sin embargo, permanece por encima de lo esperado y lo propuesto por los objetivos de desarrollo del milenio.

International Journal of Medicine and Public Health, Vol 10, Issue 1, Jan-Mar, 2020 18 Archana Thakur1, Deepti Dabar2, Abha Mangal3,*, Shailaja Daral4, Vikas Yadav5, DK Raut4 1Department of Community Medicine, Lady Hardinge Medical College, New Delhi, INDIA. 2Department of Community and Family Medicine, AIIMS, Bhopal, Madhya Pradesh, INDIA. 3Department of Community Health, St. Stephen’s Hospital, Delhi, INDIA. 4Department of Community Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, INDIA. 5Government Medical College, Vidisha, Madhya Pradesh, INDIA.

METHOD(S) : A prospective study was carried out in pre-RCH (phase I), post-RCH (phase II) and post revised Medical Termination of Pregnancy (MTP) act (phase III), to evaluate the epidemiological data of the patients of septic abortion admitted in the department of Obstetrics and ...

The main objective of this study is to determine the various determinants of septic induced abortion. Women having septic abortion were personally interviewed by the help of questionnaire at a tertiary care hospital. SPSS version 21 was used for statistical analysis. Results show that low socioeconomic status, being unmarried and lack of awareness about contraceptives are main reasons for abortion. Septic abortion may lead patients to serious infections. Government should provide easy access for legal abortions and increase its quality to avoid severe consequences.

The main objective of this study is to determine the various determinants of septic induced abortion. Women having septic abortion were personally interviewed by the help of questionnaire at a tertiary care hospital. SPSS version 21 was used for statistical analysis. Results show that low socioeconomic status, being unmarried and lack of awareness about contraceptives are main reasons for abortion. Septic abortion may lead patients to serious infections. Government should provide easy access for legal abortions and increase its quality to avoid severe consequences. Key Words: septic induced abortion; unwanted pregnancy; social determinants

Results: Nurses in hospitals reported better compliance with hand washing and maintaining head-of-bed elevation, providing regular oral care, but are not familiar with rates of ventilator-associated pneumonia and the organisms involved in this infection. Conclusion: The guidelines for the prevention of ventilatorassociated pneumonia from the CDC are not consistently or uniformly implemented. This study provides an opportunity of continuing education to nurses working in critical care areas, since majority of the nurses working in critical care areas are diploma prepared nurses and there is need to arrange regular medical intensive forums to keep them updated.

reduced in developed countries as a result of increase in awareness programs on etiological factors and prompt treatment of volume responsive cases, it is still responsible for 15-30% of AKI in developing nations. PRAKI due to ante/postpartum hemorrhage, septic abortion, and toxemia of pregnancy remains a major challenge to health care givers. Intermittent hemodialysis (HD) is the most freqent form of renal replacement therapy for AKI in developing countries including Nigeria. In recent times, there has been increased in awareness program on PRAKI, improvement in gynecological and obstetric care, and upgrading of our HD facilities. It is, however, not clear if the foregoing has translated into better outcome of PRAKI. We, therefore, undertook an 8-year retrospective study of

developed countries; it is closely linked to environmental and socioeconomic conditions. Surgery and Background. The aetiological spectrum of acute renal failure (ARF) has changed in developed countries. It trauma are the most common causes of ARF in developed countries [1-3]. Recently, the incidence of was the purpose of the study to evaluate whether similar changes have occurred in this part of the world surgical and post-traumatic ARF has decreased, whereas that of medical ARF has increased. ARF due as well. Methods. In a prospective study a total of 439 patients to septic abortion or obstetric complications has almost disappeared in developed countries, but remains signi-with ARF were evaluated. They had been admitted to one hospital during two successive periods, i.e. ficant in developing countries [1-7]. In Turkey, obstetric complications and septic abortion were the most 1983-1990 and 1991-1997. Results. Of 439 patients with ARF, 116 were admitted common causes of ARF in the 1970s [8]. The aim of this study was to assess the aetiologies in 1983-1990 (first period) and 323 in 1991-1997 (second period). The age of presentation increased and outcomes, and their trends with time, of ARF in Central Anatolia (Turkey). from 49.8±6.2 years in the first period to 58.8±16.4 years in the second. Medical causes were present in 259 cases (59%), surgical causes in 110 cases (25%), and obstetric causes in 70 cases (16%). The frequency Subjects and methods of surgical cases decreased from 28.4% in the first period to 23.8% in the second period. The respective Four hundred and thirty-three patients with ARF were figures for obstetric cases were 18.9% and 14.8%. admitted to the Nephrology Department of Erciyes Mortality did not change with time (33.6% in the first University Medical Faculty Hospital between 1983 and 1997 and 31.0% in the second period); the overall mortality in Turkey. The patient population was from the city of was 31.7%. The mortality was higher for surgical Kayseri and other cities of Central Anatolia including urban (45.5%) than for obstetric (27.8%) and medical ARF and rural areas. The total population was approximately (24.3%). 2 000 000 in which 800 000 of the people were living in the Conclusion. In the mid-1970s, the most common causes urban areas. Aetiologies and outcomes were compared in of ARF in Turkey were obstetric complications and the two successive periods, i.e. 1983-1990 (first period) and 1991-1997 (second period). ARF was defined as an acute septic abortion. The aetiological spectrum of ARF has reduction of renal function, i.e. rise in serum creatinine levels changed and today medical causes predominate. ARF to >2 mg/dl despite absence or correction of prerenal causes resulting from septic abortion has become rare, pos-[9]. Patients were classified as oliguric (less than 400 ml sibly because of liberalization of abortion in 1983 urine/24 h) or non-oliguric (more than 400 ml urine/24 h). in Turkey. The diagnosis was based on history, physical examination, laboratory values, and clinical course. All patients were

Introducción: la mortalidad materna es un indicador básico de salud y refleja el estado de salud de un país. según la OMs alrededor de 1.500 mujeres muere al día por complicaciones del embarazo y el parto; 99% de estos casos ocurre en países del tercer mundo. Objetivo: determinar la tendencia y los características asociadas con la mortalidad materna en cali en el quinquenio 2005-2010. Metodología: se realizó un estudio descriptivo retrospectivo de las defunciones maternas ocurridas entre el 1 de enero del 2005 al 31 de diciembre del 2010, analizando los datos aportados por la secretaria Municipal de salud de cali, en los cuales se incluyeron las características de estos fallecimientos, sus causas directas e indirectas y los retrasos que se presentaron en cada caso. Resultados: la razón de mortalidad materna promedio fue 60 fallecimientos por cada 100.000 nacidos vivos; 97% de casos proceden del área urbana y 70% a los estratos 1 y 2; 72% requirieron cuidados intensivos. las 5 primeras causas directas de muerte fueron choque séptico y falla orgánica múltiple (17%), insuficiencia respiratoria y choque hipovolémico (8%) respectivamente y síndrome de distress respiratorio del adulto (7%). como causas básicas están preeclampsia y aborto séptico (9%) cada una, neumonía (7%), tromboembolismo pulmonar y hemorragia postparto (4%) respectivamente. Conclusión: la tendencia de la mortalidad materna en el quinquenio 2005-2010 presentó un comportamiento hacia la mejoría, sin embargo, permanece por encima de lo esperado y lo propuesto por los objetivos de desarrollo del milenio.

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Introduction: Acute kidney injury (AKI) is a rare complication of pregnancy, but may be associated with significant morbidity and mortality in young and often otherwise healthy women. In a developing countries like Bangladesh due to low resource settings intermittent hemodialysis is the usual mode of renal replacement therapy. It opens up a field of investigation to assess the maternal and renal outcome of pregnancy associated acute kidney injury after getting dialysis. Materials and method: This analytic, descriptive, prospective study was performed over 46 patients with pregnancy associated AKI requiring dialysis during July 2015 to June 2016. Etiology and spectrum of pregnancy related acute kidney injury (PR-AKI) requiring dialysis were assessed and maternal and renal outcome were analyzed.

Background: Though abortion has been legalized in India for over three decades (Medical Termination of Pregnancy Act of 1972), unsafe abortion continues to be a significant contributor of maternal mortality and morbidity due to lack of knowledge of contraception, social pressures and untrained traditional birth attendants and health care providers. Objective: To study the profile of septic abortions, complications faced, and its management Methods: All women with features of septic abortions (n=32) were included. Observations: nearly 72% of our patients were between 26 to 35 years of age, which is the prime reproductive age group, with the majority belonging to lower socioeconomic strata. 81.2% patients underwent MTP mainly due the pregnancy being unwanted and economic issues. These were mainly conducted at home (62.5%) by untrained personnel, but surprisingly MTPs conducted at primary health centers/nursing homes also contributed to unsafe abortions (37.5%). 53% of women had the abortion in the late first trimester. All the patients had leukocytosis (100%), 19 patients presented with deranged coagulation profiles probably due to late referrals, and 53.1% had anemia of varying degrees. Only 12.4% of the cases could be managed successfully by medical treatment without any surgical intervention; the rest of them required some sort of surgical intervention. Conclusion: To reduce the morbidity and mortality associated with septic abortion, intensive dissemination of information and commitment at all levels is required, as is the use of various contraceptive methods to be promoted. Regular training courses for traditional birth attendants (dai), nurses and doctors under the supervision of expert obstetricians is recommended.

A 26 years old female G3P2L2 with a previous LSCS done 10 months back, with 15 weeks twin gestation and history of criminal abortion by quack with a wooden stick brought to us in a moribund state with complaints of high grade fever with severe pain in abdomen associated with nausea and vomiting that morning. Clinical examination revealed incomplete abortion with features of sepsis. After evaluation a diagnosis of septic abortion was established based on the clinical presentation and biochemical parameters. This case is being reported for the increased incidence of illegal unsafe abortions in rural India despite legalizations of abortion.

A 26 years old female G3P2L2 with a previous LSCS done 10 months back, with 15 weeks twin gestation and history of criminal abortion by quack with a wooden stick brought to us in a moribund state with complaints of high grade fever with severe pain in abdomen associated with nausea and vomiting that morning. Clinical examination revealed incomplete abortion with features of sepsis. After evaluation a diagnosis of septic abortion was established based on the clinical presentation and biochemical parameters. This case is being reported for the increased incidence of illegal unsafe abortions in rural India despite legalizations of abortion.

Background. Acute kidney injury (AKI) has increasingly been recognized as an important public health issue due to its rising frequency, its associations with early and late adverse outcomes and its economic burden. Methods. Given the importance of determining the available resources to address this serious issue, the AKI Committee of SLANH conducted a survey to obtain information about infrastructure, human resources and equipment devoted to the treatment of AKI in Latin America Results. A total of 246 units from 14 countries participated in the survey, the majority of them pertaining to nephrology divisions in teaching hospitals. Intermittent hemodialysis was universally performed by all of the units, and less frequently, slow extended dialysis (40%) and continuous renal replacement therapy (23%) were performed. Seventy-nine units (30%) perform peritoneal dialysis, but only 51 (19%) of them reported having treated at least 1 patient with this technique in the last 3 months pre-survey. The vast majority of the units reported adequate water treatment and use of modern filter membranes. Most of the patients received renal replacement therapy (RRT) in the intensive care unit. Specific causes of AKI were reported in different frequencies, with a heterogeneous pattern among the countries. Septic abortion, hemolytic-uremic syndrome, community-acquired diarrhea and leptospirosis were the etiologies most frequently associated with AKI. Conclusions. To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

Enteric fever, caused byserotype Typhi (typhoid fever) orserotype Paratyphi A, B or C (paratyphoid fever), is a major health problem in developing countries. Vertical transmission ofcan cause miscarriage, still birth, preterm labour and neonatal sepsis. In the literature, many cases of vertical transmission ofTyphi from mother to foetus have been reported, but there are very limited studies showing vertical transmission ofParatyphi.Here, we report a rare case ofserotype Paratyphi A infection in a pregnant woman resulting in a spontaneous miscarriage.serotype Paratyphi A was isolated from placental membrane in culture.A high index of suspicion, along with timely cultures of relevant samples, like blood and stool, and timely initiation of antibiotic therapy in pregnancy could possibly save the lives of such foetuses.

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I 2

Young unmarried women in India are subject to cultural barriers associated with being sexually active - such as social conservatism and gender-based discrimination. 1 India has a growing population essentially consisting of adolescents and young adults: 10-24 years, who make up
33% (253 million: as per 2011 census) of our population; a figure much higher than Western countries. 2 While there is an increase in sexual promiscuity in the Indian adolescent population, it is not supplemented by an appropriate increase in awareness regarding sexual health information
- leading to a rise in sexually transmitted diseases and higher abortion rates. 3 These abortions are complicated with serious adverse events as women undergo untimely procedures with 75% of individuals falling between 18-19 years of age. 4,5 Our piece focuses on unmarried, sexually
active women residing in urban India. The purpose of this correspondence is to highlight the obstacles associated with contraceptive seeking behaviour, especially stigma - perceived, anticipated and experienced,
and we’d like to explore the reasons for the same.

Background: The recent years have seen rise in unintended pregnancy which includes unwanted and mistimed pregnancy. Despite the conducive environment of legal abortion in India through MTP Act, many women resort to unsafe methods of abortion. In India, estimated abortions in 2015 were 15.6 million. The overall rate of abortion was estimated to be 4.8%, among which 67.1% of abortions were classified to be unsafe. Thus, the aim of the study is to analyze the demographic profile of patients, reason for seeking abortion and evaluation of significant adverse outcome and management.
Materials and Methods: This was a hospital-based observation study carried out in the department of OBG in MMC&RI, Mysuru during the period January 2019 to December 2020. 100 women seeking MTP and 100 women presenting to hospital for help following the consumption of over the counter pills were included in the study.
Results: 100 women with self-consumption of pills presented to hospital with complaints of heavy bleeding (35%), spotting PV (22%) and pain abdomen (15%). Most were married, belonging to lower socioeconomic status with age of 21-25 years (42%), followed by 26 – 30 years (22%). In 100 women seeking MTP, congenital fetal anomalies (51%) was the main indication, followed by contraception failure (36%). In comparison to the women seeking abortion services under medical supervision, the complication rates were higher in unsupervised group. This included retained products of conception (25%), moderate anemia (12%), severe anemia (7%), shock (3%), sepsis (4%) requiring surgical evacuation (51%), medical management (46%), anemia correction (17%), ICU admission (7%) and emergency laparotomy (3%).
Conclusion: The cornerstone is motivation and encouragement of women to adapt family planning services to reduce unintended pregnancy. For women needing these services, accessibility and comprehensive education regarding unsafe abortion is needed. Legislation and strict policy is required for the use of MTP pills, so as to reduce the sales without prescription.

Keywords: Unsafe abortions, MTP, Unintended pregnancy, Family planning.

This article describes a programme to scale up post-abortion care services in 22 of the 33 public sector district hospitals in Guatemala from July 2003 to December 2004. The main interventions included strengthening the knowledge and technical capacity of staff, expanding post-abortion care, enhancing related infrastructure, distributing informational materials and instituting an abortion surveillance system. A facilitator supported the work through week-long, monthly visits at each hospital. Attention was also devoted to building institutional consensus in support of post-abortion care at government, district hospital and hospital staff levels. During this period, 13,928 women with incomplete abortions were admitted to the 22 hospitals. Use of manual vacuum aspiration for treatment of incomplete first trimester abortion increased from 38% to 68% of cases (pb0.0001). Provision of family planning counselling also increased, from 31% to 78% of women (pb0.0001), and the proportion of women selecting a contraceptive method before leaving hospital from 20% to 49% (pb0.0001). Infection was associated with 71% of the incomplete abortions, of which 90% were septic. There were nine deaths and 768 women suffered severe complications, the level of which remained unchanged during the study period. Guatemala still has much to do to institutionalise post-abortion care fully and reduce deaths and complications, but our efforts to date will be valuable to others.

GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Cochrane Library Trusted evidence. Informed decisions. Better health.

Article Citation ABSTRACT…..Background & Objective: Acute renal failure is one of serious complication in pregnancy, in first trimester is usually related to unregulated and septic miscarriage while in third trimester it is due to obstetric complications. This prospective case serious descriptive study was conducted to determine the frequency, etiology and outcome of patients suffering from acute renal failure.

Background. Acute kidney injury (AKI) has increasingly been recognized as an important public health issue due to its rising frequency, its associations with early and late adverse outcomes and its economic burden. Methods. Given the importance of determining the available resources to address this serious issue, the AKI Committee of SLANH conducted a survey to obtain information about infrastructure, human resources and equipment devoted to the treatment of AKI in Latin America Results. A total of 246 units from 14 countries participated in the survey, the majority of them pertaining to nephrology divisions in teaching hospitals. Intermittent hemodialysis was universally performed by all of the units, and less frequently, slow extended dialysis (40%) and continuous renal replacement therapy (23%) were performed. Seventy-nine units (30%) perform peritoneal dialysis, but only 51 (19%) of them reported having treated at least 1 patient with this technique in the last 3 months pre-survey. The vast majority of the units reported adequate water treatment and use of modern filter membranes. Most of the patients received renal replacement therapy (RRT) in the intensive care unit. Specific causes of AKI were reported in different frequencies, with a heterogeneous pattern among the countries. Septic abortion, hemolytic-uremic syndrome, community-acquired diarrhea and leptospirosis were the etiologies most frequently associated with AKI. Conclusions. To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

Se puede consultar en el apéndice las filiaciones de los coordinadores de sección. Los miembros del Comité de la ESC para la Elaboración de GPC y los revisores del documento representantes de las sociedades nacionales de cardiología aparecen listados en el apéndice. Entidades de la ESC que han participado en el desarrollo de este documento: Asociaciones:

The incidence of acute kidney injury in pregnancy declined significantly over the second half of the 20th century; however, it is still associated with major maternal and perinatal morbidity and mortality. A set of systemic and renal physiological adaptive mechanisms occur during a normal gestation that will constrain several changes in laboratory parameters of renal function, electrolytes, fluid and acid-base balances. The diagnosis of acute kidney injury in pregnancy is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate are not validated in this population. During the first trimester of gestation, acute kidney injury develops most often due to hyperemesis gravidarum or septic abortion. In the third trimester, the differential diagnosis is more challenging for the obstetrician and the nephrologist and comprises some pathologies that are reviewed in this article: preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies.

Background & objective: Among the gynaecological cases admitted in tertiary care hospitals, abortion occupies the highest position. But detailed studies about the pattern of abortion admitted in the hospitals are limited. The present study was intended to find the proportion of abortion cases to total admitted cases and describe the types, clinical presentation and consequences of abortions. Methods: This study was carried out among a cross-section of abortion patients admitted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital. A total of 100 women admitted with a history of abortion between January and June, 2003 were consecutively included in the study. On admission, blood sample was sent for blood grouping & cross-matching and estimation of haemoglobin. Additional investigations like routine blood test, TC, DC, urine for R/E were done in septic abortion cases. High vaginal swab was collected from all cases but only in 5 patients, it was possible to c...

Image. Point-of-care ultrasonographic transabdominal images of the uterus in midline (A) and off-axis sagittal views (B), demonstrating an enlarged uterus (dotted line) with irregular echogenic endometrial debris (asterisk) casting shadows from the endometrium. Video. Transabdominal ultrasound of the uterus with debris and air with shadowing artifact.

To assess the feasibility of establishing a simple maternal morbidity surveillance system in Assam (Indian Obstetric Surveillance System-Assam (IndOSS-Assam)) to investigate the incidence and trends in severe maternal complications. This study presents the surveillance platform of IndOSS-Assam. Four tasks were undertaken: (1) setting up of a steering committee; (2) establishing priorities for the region; (3) mapping of surveillance sites; (4) piloting case-notification systems in selected centres. Two government tertiary hospitals in the state. Pregnant women delivering in the hospitals between March and August 2015. Incidence and case fatality rates with 95% CIs. Local stakeholder ownership and a simple uncomplicated anonymous system for case notification were the key strengths of this project. Cases and deaths were reported for six conditions: eclampsia, postpartum haemorrhage, puerperal sepsis, septic abortion, uterine rupture and anaemic heart failure. Among 10 475 women deliver...

Background. Acute kidney injury (AKI) has increasingly been recognized as an important public health issue due to its rising frequency, its associations with early and late adverse outcomes and its economic burden. Methods. Given the importance of determining the available resources to address this serious issue, the AKI Committee of SLANH conducted a survey to obtain information about infrastructure, human resources and equipment devoted to the treatment of AKI in Latin America Results. A total of 246 units from 14 countries participated in the survey, the majority of them pertaining to nephrology divisions in teaching hospitals. Intermittent hemodialysis was universally performed by all of the units, and less frequently, slow extended dialysis (40%) and continuous renal replacement therapy (23%) were performed. Seventy-nine units (30%) perform peritoneal dialysis, but only 51 (19%) of them reported having treated at least 1 patient with this technique in the last 3 months pre-survey. The vast majority of the units reported adequate water treatment and use of modern filter membranes. Most of the patients received renal replacement therapy (RRT) in the intensive care unit. Specific causes of AKI were reported in different frequencies, with a heterogeneous pattern among the countries. Septic abortion, hemolytic-uremic syndrome, community-acquired diarrhea and leptospirosis were the etiologies most frequently associated with AKI. Conclusions. To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

Se revisaron diversas fuentes bibliográficas sobre endocarditis infecciosa, especialmente las que trataban aspectos clinicoepidemiológicos, diagnósticos y terapéuticos, a fin de confeccionar un trabajo que constituya un material para el estudio y la actualización de este tema; no obstante, se consideró la necesidad de continuar dicha investigación sobre otras determinadas características de esta infección para ampliar los conocimientos al respecto.

OBJETIVO: Determinar la tasa de mortalidad materna hospitalaria, así como las causas más frecuentes. DISEÑO: Estudio retrospectivo, descriptivo, transversal. MATERIAL Y MÉTODOS: Cincuenta y tres casos de muerte materna ocurridos en el Hospital Nacional Arzobispo Loayza (HNAL), hospital general y de referencia, entre enero de 1994 y diciembre de 2004. RESULTADOS: La tasa de mortalidad materna entre enero 1994 y diciembre 2004 fue 115,4 por 100 000 nv. El promedio anual de muertes fue de 4,8. La edad más frecuente estuvo entre 30 y 40 años, con 22,6%. No hubo muertes maternas en menores de 15 años y mayores de 45 años. Las muertes fueron más frecuentes durante el puerperio, con 71,7%. Predominaron las muertes de causa directa, con 64,2%, siendo las principales infección (30,2%), hipertensión (26,4%) y hemorragia (7,5%). De las causas directas, destacan el aborto séptico y la eclampsia, con 26,5% cada una. Durante los últimos 5 años, 64% de las muertes fueron evitables. CONCLUSIONES: L...

International Journal of Medicine and Public Health, Vol 10, Issue 1, Jan-Mar, 2020 18 Archana Thakur1, Deepti Dabar2, Abha Mangal3,*, Shailaja Daral4, Vikas Yadav5, DK Raut4 1Department of Community Medicine, Lady Hardinge Medical College, New Delhi, INDIA. 2Department of Community and Family Medicine, AIIMS, Bhopal, Madhya Pradesh, INDIA. 3Department of Community Health, St. Stephen’s Hospital, Delhi, INDIA. 4Department of Community Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, INDIA. 5Government Medical College, Vidisha, Madhya Pradesh, INDIA.

Background: Maternal mortality is an important indicator of women's health and social well-being. According to the WHO report, each year, an estimated 190 women for every 100,000 live births die due to maternal causes. In India, unsafe abortion and related complications accounts for 9% of all maternal deaths. Abortion was made legal in India by the Medical Termination of Pregnancy (MTP) act, which was enacted by Indian Parliament in the year 1971. But the number of unsafe abortions has not declined. Methods: A present study was conducted by the

This article describes a programme to scale up post-abortion care services in 22 of the 33 public sector district hospitals in Guatemala from July 2003 to December 2004. The main interventions included strengthening the knowledge and technical capacity of staff, expanding post-abortion care, enhancing related infrastructure, distributing informational materials and instituting an abortion surveillance system. A facilitator supported the work through week-long, monthly visits at each hospital. Attention was also devoted to building institutional consensus in support of post-abortion care at government, district hospital and hospital staff levels. During this period, 13,928 women with incomplete abortions were admitted to the 22 hospitals. Use of manual vacuum aspiration for treatment of incomplete first trimester abortion increased from 38% to 68% of cases (pb0.0001). Provision of family planning counselling also increased, from 31% to 78% of women (pb0.0001), and the proportion of women selecting a contraceptive method before leaving hospital from 20% to 49% (pb0.0001). Infection was associated with 71% of the incomplete abortions, of which 90% were septic. There were nine deaths and 768 women suffered severe complications, the level of which remained unchanged during the study period. Guatemala still has much to do to institutionalise post-abortion care fully and reduce deaths and complications, but our efforts to date will be valuable to others.

This article describes a programme to scale up post-abortion care services in 22 of the 33 public sector district hospitals in Guatemala from July 2003 to December 2004. The main interventions included strengthening the knowledge and technical capacity of staff, expanding post-abortion care, enhancing related infrastructure, distributing informational materials and instituting an abortion surveillance system. A facilitator supported the work through week-long, monthly visits at each hospital. Attention was also devoted to building institutional consensus in support of post-abortion care at government, district hospital and hospital staff levels. During this period, 13,928 women with incomplete abortions were admitted to the 22 hospitals. Use of manual vacuum aspiration for treatment of incomplete first trimester abortion increased from 38% to 68% of cases (pb0.0001). Provision of family planning counselling also increased, from 31% to 78% of women (pb0.0001), and the proportion of women selecting a contraceptive method before leaving hospital from 20% to 49% (pb0.0001). Infection was associated with 71% of the incomplete abortions, of which 90% were septic. There were nine deaths and 768 women suffered severe complications, the level of which remained unchanged during the study period. Guatemala still has much to do to institutionalise post-abortion care fully and reduce deaths and complications, but our efforts to date will be valuable to others.

To assess the feasibility of establishing a simple maternal morbidity surveillance system in Assam (Indian Obstetric Surveillance System-Assam (IndOSS-Assam)) to investigate the incidence and trends in severe maternal complications. This study presents the surveillance platform of IndOSS-Assam. Four tasks were undertaken: (1) setting up of a steering committee; (2) establishing priorities for the region; (3) mapping of surveillance sites; (4) piloting case-notification systems in selected centres. Two government tertiary hospitals in the state. Pregnant women delivering in the hospitals between March and August 2015. Incidence and case fatality rates with 95% CIs. Local stakeholder ownership and a simple uncomplicated anonymous system for case notification were the key strengths of this project. Cases and deaths were reported for six conditions: eclampsia, postpartum haemorrhage, puerperal sepsis, septic abortion, uterine rupture and anaemic heart failure. Among 10 475 women deliver...

Background. Acute kidney injury (AKI) has increasingly been recognized as an important public health issue due to its rising frequency, its associations with early and late adverse outcomes and its economic burden. Methods. Given the importance of determining the available resources to address this serious issue, the AKI Committee of SLANH conducted a survey to obtain information about infrastructure, human resources and equipment devoted to the treatment of AKI in Latin America Results. A total of 246 units from 14 countries participated in the survey, the majority of them pertaining to nephrology divisions in teaching hospitals. Intermittent hemodialysis was universally performed by all of the units, and less frequently, slow extended dialysis (40%) and continuous renal replacement therapy (23%) were performed. Seventy-nine units (30%) perform peritoneal dialysis, but only 51 (19%) of them reported having treated at least 1 patient with this technique in the last 3 months pre-survey. The vast majority of the units reported adequate water treatment and use of modern filter membranes. Most of the patients received renal replacement therapy (RRT) in the intensive care unit. Specific causes of AKI were reported in different frequencies, with a heterogeneous pattern among the countries. Septic abortion, hemolytic-uremic syndrome, community-acquired diarrhea and leptospirosis were the etiologies most frequently associated with AKI. Conclusions. To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.