Master of Medicine in Obstetrics, Reproductive Health and Gynecology

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http://hdl.handle.net/20.500.12493/14840

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Browsing Master of Medicine in Obstetrics, Reproductive Health and Gynecology by Author "Guled Bashir Abdi"

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    Prevalence, Bacteriological Trends and Factors Associated with Septic Abortion among Women Attending Hoima and Fortportal Regional Referral Hospitals Western Uganda
    (Kampala International University, 2023-05) Guled Bashir Abdi
    Background: Septic abortion is clinical evidence of infection of the uterus and its contents. Lack of antiseptic and asepsis, inadequate evacuation, and inadvertent damage to the genital organs, can cause infection to arise during or soon after an abortion. Most infections experienced in septic abortion are polymicrobial. WHO estimates that 68,000 die annually due to complications of unsafe abortion with sepsis as the primary cause of death. Globally post abortion infection accounts for 22.1% of severe maternal illnesses and 9.5% of the global burden of maternal infections. In women with septic abortion, we aimed to identify prevalence, bacteriological trends and associated factors in women admitted two tertiary hospitals in Uganda. Methodology: This hospital based cross-sectional study was carried out from September 2022 to January 2023. Using a consecutive sampling method, 207 septic abortion women were enrolled. Data on socio-demographics and other factors associated with septic abortion were collected using pre-tested structured questionnaires. Endocervical swab was taken for culture and sensitivity by disc diffusion modified Kirby-Bauer’s method on Mueller Hinton agar. Data was analyzed using SPSS version 23. A bivariable and multivariable logistic regression model were used to show association between the dependent and independent variables considering P < 0.05 and the 95% confidence interval. Results: The prevalence of septic abortion was 13%. Endocervical isolates from women with septic abortion in this study were poly microbial infections, with 48.1% were Escherichia coli followed by Staphylococcus aureus 18.5%, and Citrobacter spp 11.1%. In 90% of cases organism were sensitive to Imipenem, Peperacillin Tazobactam, Chloramphenicol and Vancomycin. A high resistance was noted with Ampicillin, Augmentine and cefotaxime. In this study, no history of contraceptives uses, being residence from rural areas were the two factors found to be significantly associated with septic abortion. Conclusion: In this study, the prevalence of septic abortion was high compared to the global level. There is need to intense health education and awareness on danger of septic abortion by health care authorities. Health care providers should provide close surveillance and special care with women from rural residence and those with no history of contraceptive use.