Sante. 2000 Jul-Aug; 10(4): 243-7.

[Complications of illegal induced abortions at Bamako (Mali) between December 1997 and November 1998]

Diallo FS, TraorÃ© M, DiakitÃ© S, Perrotin F, DembÃ©lÃ© F, Diarra I, Dolo A.

We carried out a descriptive retrospective study over a period of one year, in the Gynecology and Obstetrics Referrals Department of Gabriel-TourÃ© Hospital at Bamako. We analyzed 1,081 files of patients presenting at the department with complications of spontaneous or induced abortion. We identified and studied 189 cases of illegal induced abortions. The patients were young (mean age 21.8 years), of a low socioeconomic level and most (71.4%) had no living child. The gestational age of the fetus was less than 12 weeks for 19.5% of the women and between 13 and 16 weeks for 47.6%. The abortions were carried out by traditional practitioners (3.7%), general practitioners (9%), trainee nurses (10.5%) and state nurses and midwives (57.1%). In more than half the cases (71.4%), the abortion took place at the home of the practitioner. Several methods of abortion were used (e.g. curettage, uterine probes). In 44.4% of the cases, the woman refused to comment on the reasons for the abortion. The other women cited mostly academic reasons (20.63% of cases) and fear of their parents (13.22%). The main reasons for consultation were bleeding (51.3%), hyperthermia (35.4%), pain (9. 52%) and neurological problems (3.1%). Three types of complication were identified: bleeding (47%), infectious complication (33.3%) and drug poisoning (4.2%). The rate of maternal mortality was 10% and the management of the patients required surgical (from curettage to hysterectomy) and medical treatment, with a mean stay in hospital of 10 days.