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Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda

INTRODUCTION: With a view to inform policy for improved postabortion care, we describe abortion-related near-miss and mortality by sociodemographic risk factors and management options by pregnancy trimester in Uganda. METHODS: This secondary data analysis used an adapted WHO near-miss methodology to...

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Autores principales: Atuhairwe, Susan, Gemzell-Danielsson, Kristina, Byamugisha, Josaphat, Kaharuza, Frank, Tumwesigye, Nazarius Mbona, Hanson, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871269/
https://www.ncbi.nlm.nih.gov/pubmed/33547174
http://dx.doi.org/10.1136/bmjgh-2020-003274
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author Atuhairwe, Susan
Gemzell-Danielsson, Kristina
Byamugisha, Josaphat
Kaharuza, Frank
Tumwesigye, Nazarius Mbona
Hanson, Claudia
author_facet Atuhairwe, Susan
Gemzell-Danielsson, Kristina
Byamugisha, Josaphat
Kaharuza, Frank
Tumwesigye, Nazarius Mbona
Hanson, Claudia
author_sort Atuhairwe, Susan
collection PubMed
description INTRODUCTION: With a view to inform policy for improved postabortion care, we describe abortion-related near-miss and mortality by sociodemographic risk factors and management options by pregnancy trimester in Uganda. METHODS: This secondary data analysis used an adapted WHO near-miss methodology to collect cross-sectional maternal near-miss and abortion complications data at 43 health facilities in Central and Eastern Uganda in 2016–2017. We computed abortion severe morbidity, near-miss and mortality ratios per 100 000 live births, and described the proportion of cases that worsened to an abortion near-miss or death, stratified by geographical region and trimester. We tested for association between independent variables and abortion near-miss, and obtained prevalence ratios for association between second trimester near-miss and independent demographic and management indicators. We assessed health facility readiness for postabortion care provision in Central and Eastern regions. RESULTS: Of 3315 recorded severe abortion morbidity cases, 1507 were near-misses. Severe abortion morbidity, near-miss and mortality ratios were 2063, 938 and 23 per 100 000 live births, respectively. Abortion-related mortality ratios were 11 and 57 per 100 000 in Central and Eastern regions, respectively. Abortion near-miss cases were significantly associated with referral (p<0.001). Second trimester had greater abortion mortality than first trimester. Eastern region had greater abortion-related morbidity and mortality than Central region with facilities in the former characterised by inferior readiness to provide postabortion care. CONCLUSIONS: Uganda has a major abortion near-miss morbidity and mortality; with mortality higher in the second trimester. Life-saving commodities are lacking especially in Eastern region compromising facility readiness for postabortion care provision.
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spelling pubmed-78712692021-02-18 Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda Atuhairwe, Susan Gemzell-Danielsson, Kristina Byamugisha, Josaphat Kaharuza, Frank Tumwesigye, Nazarius Mbona Hanson, Claudia BMJ Glob Health Original Research INTRODUCTION: With a view to inform policy for improved postabortion care, we describe abortion-related near-miss and mortality by sociodemographic risk factors and management options by pregnancy trimester in Uganda. METHODS: This secondary data analysis used an adapted WHO near-miss methodology to collect cross-sectional maternal near-miss and abortion complications data at 43 health facilities in Central and Eastern Uganda in 2016–2017. We computed abortion severe morbidity, near-miss and mortality ratios per 100 000 live births, and described the proportion of cases that worsened to an abortion near-miss or death, stratified by geographical region and trimester. We tested for association between independent variables and abortion near-miss, and obtained prevalence ratios for association between second trimester near-miss and independent demographic and management indicators. We assessed health facility readiness for postabortion care provision in Central and Eastern regions. RESULTS: Of 3315 recorded severe abortion morbidity cases, 1507 were near-misses. Severe abortion morbidity, near-miss and mortality ratios were 2063, 938 and 23 per 100 000 live births, respectively. Abortion-related mortality ratios were 11 and 57 per 100 000 in Central and Eastern regions, respectively. Abortion near-miss cases were significantly associated with referral (p<0.001). Second trimester had greater abortion mortality than first trimester. Eastern region had greater abortion-related morbidity and mortality than Central region with facilities in the former characterised by inferior readiness to provide postabortion care. CONCLUSIONS: Uganda has a major abortion near-miss morbidity and mortality; with mortality higher in the second trimester. Life-saving commodities are lacking especially in Eastern region compromising facility readiness for postabortion care provision. BMJ Publishing Group 2021-02-05 /pmc/articles/PMC7871269/ /pubmed/33547174 http://dx.doi.org/10.1136/bmjgh-2020-003274 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Research
Atuhairwe, Susan
Gemzell-Danielsson, Kristina
Byamugisha, Josaphat
Kaharuza, Frank
Tumwesigye, Nazarius Mbona
Hanson, Claudia
Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title_full Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title_fullStr Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title_full_unstemmed Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title_short Abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in Uganda
title_sort abortion-related near-miss morbidity and mortality in 43 health facilities with differences in readiness to provide abortion care in uganda
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871269/
https://www.ncbi.nlm.nih.gov/pubmed/33547174
http://dx.doi.org/10.1136/bmjgh-2020-003274
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