Browsing by Subject "Abortion, Induced"
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Item Evaluation of the use of barrier contraceptives in women requesting termination of pregnancy at CHBAH(2015-04-22) Maswime, Tumishang Mmamalatsi SalomeIntroduction South Africa has a high prevalence of unintended pregnancies and HIV. Sixty eight thousand women die due to unsafe abortion annually worldwide, making it a leading cause of maternal mortality. In SA the maternal mortality has decreased from TOP. Maternal mortality from HIV is the leading cause of maternal mortality in South Africa. Unintended pregnancies are mainly a consequence of inconsistent and incorrect contraceptive use. The condom is the only contraceptive method which has the dual ability of preventing HIV and unintended pregnancies. We postulate that the failure of barrier contraception is a risk for both HIV and unwanted pregnancy. This study describes the contraceptive methods used by women at a TOP clinic and evaluates the use of barrier contraceptives amongst women requesting TOP, and the prevalence of HIV. Methods CHBAH is tertiary hospital in Southern Gauteng. Women with medical or surgical comorbidities that request a TOP are referred to the hospital. A prospective study using a cross sectional study design was performed at the Chris Hani Baragwanath Academic Hospital TOP clinic between February and October 2011. Data was collected using interviews and medical files. Results One hundred and nineteen women were interviewed. Most women 56 (47.06%) did not use any contraception at the time of conception. The most common reason for TOP was financial constraints, followed by relationship conflict. Pregnancy despite condom use was 34.45% (n=41). The percentage of women with condom failure, who were HIV positive was 34.14% (n=14). True condom failure was experienced by 12 women (pregnancy due to breakage/slippage of the condom. Conclusion Unintended pregnancy is mainly associated with not using contraceptives. The male condom was the most widely used contraceptive. The HIV prevalence in the group with condom failure was higher than the general antenatal population. There is a need for education regarding correct and consistent use of contraception.Item Second trimester termination of pregnancy at Chris Hani Baragwanath academic hospital(2015-04-07) Baloyi, StephenObjectives: The main objective of this study was to characterise women who presented at Chris Hani Baragwanath Academic Hospital (CHBAH) between 12 and 20 weeks for termination of pregnancy (TOP). Secondary objectives were to determine time to abortion, compare sonar gestational age to gestational age by dates and reasons for late presentation. Method: This was a prospective cohort study of women over the age of 18 who were referred to CHBAH for second trimester TOP between August 2012 and May 2013. The exclusion criteria were pregnancies more advanced than 20 weeks gestation. Data was collected from the medical file and by interview. Demographics and reasons to terminate were extracted from the files. Outcome variables included bleeding, pain, and time to abortion. Results: One hundred and ninety one women (91.39%) aborted. The median age of women was 25.00 (IQR=21.00-31.00), range (18-43). Women older than 25 years were 33% less likely to abort than women less than 25 years of age. Ninety nine women (47.14%) bled severely. One woman had a uterine perforation following evacuation of the uterus. The median gestational age by sonar was14.71 (IQR=13.86-16.14), range (13.00-20.00). The median gestational age by dates was13.57 (IQR=12.29-15.00), range (4.14-26.28). One hundred and thirty five women (63.98%) had an MVA for RPOC using analgesia following medical induction. Two women (0.95%) needed hysterotomy following failed TOP. The median time to abortion was 11.50(IQR=8.67-17.92), range (3.50-69.33) and incidence rate of 0.5 per hour or 1 per 2hours. Conclusion: The majority of women (91%) aborted within 72 hours following medical induction with less complication rate and short induction to abortion time. This affirm misoprostol efficacy as the suitable drug for conducting second trimester medical TOP.Item Self- induction of abortion among women accessing second- trimester abortion services in the public sector, Western Cape Province, South Africa : An exploratory study(2014-04) Constant, D; Grossman, D; Lince, N; et alBackground: Despite South Africa's liberal abortion law permitting abortion on request in the first trimester and under restricted conditions for second-trimester pregnancies, the practice of unsafe self-induced abortion persists. However, the prevalence of this practice, the methods used and the reasons behind it are relatively under-researched. As part of a larger study seeking to improve abortion services in the Western Cape Province, we explored reports of prior attempts to self-induce abortion among women undergoing legal second-trimester abortion. Objectives: To describe the prevalence and methods of and factors related to unsuccessful attempts at self-induction of abortion by women presenting without complications and seeking second-trimester abortion at public health facilities in the Western Cape. Methods: In a cross-sectional study from April to August 2010, 194 consenting women undergoing second-trimester abortion were interviewed by trained fieldworkers using structured questionnaires at four public sector facilities near Cape Town. Results: Thirty-four women (17.5%; 95% confidence interval 12.7 - 23.4) reported an unsuccessful attempt to self-induce abortion during the current pregnancy before going to a facility for second-trimester abortion. No factors were significantly associated with self-induction, but a relatively high proportion of this small sample were unemployed and spoke an indigenous African language at home. A readily available herbal product called Stametta was most commonly used; other methods included taking tablets bought from unlicensed providers and using other herbal remedies. No use of physical methods was reported. Conclusions: The prevalence of unsafe self-induction of abortion is relatively high in the Western Cape. Efforts to inform women in the community about the availability of free services in the public sector and to educate them about the dangers of self-induction and unsafe providers should be strengthened to help address this public health issue.