Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A)
Abstract: This study aimed to describe the severity of abortion-related complications, factors associated with complications, the types of management and the experience of care in Brazil. A cross-sectional study in twenty hospitals (10 in Federal District, 3 in Rondônia and 7 in Maranhão). For 3 mon...
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Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz
2025-01-01
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2024001001414&lng=en&tlng=en |
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| author | Nelio Neves Veiga Junior Luiz Francisco Cintra Baccaro Adriana Mendonça da Silva Alexandrino Alexandre Volta Andrade do Nascimento Camila Tereza Camilo Clerot Cintya Andreia do Nascimento Santos Claudia Lucrécia de Matos Silva Claudio Lucio de Medeiros Albuquerque Débora Paulo Santos Demétrio Antonio Gonçalves da S. Gomes Édson Cunha de Araújo Junior Elizabete das Chagas Vilanova Georgina Costa Teixeira Graciete Helena Nascimento dos Santos Guilherme Augusto Guerra Avelar Iara Elce Lopes Barros Jaqueline Polon Abboud Jeane Cristina Antas Lins Joanne Thalita Pereira Silva Kelma H. Aguiar de Lucena Lara Wanderley Paes Barbosa Lia Ferreira Caixeta Barreto de Siqueira Luciana de Melo Freitas Carneiro Lucila Nagata Márcia de Oliveira Pereira Lúcio Maria Cleane Rodrigues da Silva Maria da Conceição Ribeiro Simões Maria Fernanda da Mota Magalhães Mariana Viana Almeida Michelle Regina Faria Lira Nádia Martins de Paula Souza Rafael Martins Papa Rafael Ribeiro Matos Renata Porto Pinheiro Roberta Souza dos Anjos Suelen Miranda de Jesus Tedy Roger Flores Ynturias Valéria Cristina Gonçalves Viviane Resende de Abreu Caetano |
| author_facet | Nelio Neves Veiga Junior Luiz Francisco Cintra Baccaro Adriana Mendonça da Silva Alexandrino Alexandre Volta Andrade do Nascimento Camila Tereza Camilo Clerot Cintya Andreia do Nascimento Santos Claudia Lucrécia de Matos Silva Claudio Lucio de Medeiros Albuquerque Débora Paulo Santos Demétrio Antonio Gonçalves da S. Gomes Édson Cunha de Araújo Junior Elizabete das Chagas Vilanova Georgina Costa Teixeira Graciete Helena Nascimento dos Santos Guilherme Augusto Guerra Avelar Iara Elce Lopes Barros Jaqueline Polon Abboud Jeane Cristina Antas Lins Joanne Thalita Pereira Silva Kelma H. Aguiar de Lucena Lara Wanderley Paes Barbosa Lia Ferreira Caixeta Barreto de Siqueira Luciana de Melo Freitas Carneiro Lucila Nagata Márcia de Oliveira Pereira Lúcio Maria Cleane Rodrigues da Silva Maria da Conceição Ribeiro Simões Maria Fernanda da Mota Magalhães Mariana Viana Almeida Michelle Regina Faria Lira Nádia Martins de Paula Souza Rafael Martins Papa Rafael Ribeiro Matos Renata Porto Pinheiro Roberta Souza dos Anjos Suelen Miranda de Jesus Tedy Roger Flores Ynturias Valéria Cristina Gonçalves Viviane Resende de Abreu Caetano |
| author_sort | Nelio Neves Veiga Junior |
| collection | DOAJ |
| description | Abstract: This study aimed to describe the severity of abortion-related complications, factors associated with complications, the types of management and the experience of care in Brazil. A cross-sectional study in twenty hospitals (10 in Federal District, 3 in Rondônia and 7 in Maranhão). For 3 months, all women treated for abortion/miscarriage had their data collected. The severity of complications was defined according to World Health Organization criteria. Women with hemorrhage, infection or organs injury were invited to answer an interview about experience of care. Statistical analysis was performed using chi-square test and Poisson regression models. Among 1,683 women included, 82.5% had mild complications, 13.6% had moderate complications, 3.2% had potentially life-threatening conditions (PLTC) and 0.7% had severe maternal outcomes (SMO). Most women (94.2%) required uterine evacuation. Among these, 91.5% required surgical evacuation (with or without the use of uterotonics) and 8.5% used only uterotonics. The most frequent surgical evacuation method was curettage (66.9%), followed by manual vacuum aspiration (MVA) (32.3%). Factors associated with PLTC/SMO vs mild complications were having a gestational age ≥ 13 weeks (pravlence ratio - PR = 3.09; 95% confidence interval - 95%CI: 1.42-6.72), having been treated in Maranhão (PR = 0.27; 95%CI: 0.12-0.63) and in Rondônia (PR = 0.64; 95%CI: 0.20-0.99). Factors associated with moderate vs. mild complications were expulsion of products of conception before arrival to health facility (PR = 2.55; 95%CI: 1.64-3.96) and having been treated in Maranhão (PR = 0.58; 95%CI: 0.38-0.87). Most women who responded to the interview were treated kindly (95.6%), however, 66.7% felt stressed and 10.1% reported that their preferences were not respected during hospitalization. Nine out of ten women treated in Brazilian public hospitals due to abortion-related complications undergo some surgical procedure, the most common of which is uterine curettage. Approximately four in every hundred women experience severe complications. It is essential to ensure the supply of equipment for MVA and to encourage continuing medical education programs to increase the awareness of healthcare professionals about safer treatments for uterine evacuation. |
| format | Article |
| id | doaj-art-12ef852feedc4346944bc6746eafb80f |
| institution | Kabale University |
| issn | 1678-4464 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz |
| record_format | Article |
| series | Cadernos de Saúde Pública |
| spelling | doaj-art-12ef852feedc4346944bc6746eafb80f2025-01-21T07:40:29ZengEscola Nacional de Saúde Pública, Fundação Oswaldo CruzCadernos de Saúde Pública1678-44642025-01-01401010.1590/0102-311xen010624Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A)Nelio Neves Veiga Juniorhttps://orcid.org/0000-0002-3977-0817Luiz Francisco Cintra Baccarohttps://orcid.org/0000-0002-8837-8061Adriana Mendonça da Silva AlexandrinoAlexandre Volta Andrade do NascimentoCamila Tereza Camilo ClerotCintya Andreia do Nascimento SantosClaudia Lucrécia de Matos SilvaClaudio Lucio de Medeiros AlbuquerqueDébora Paulo SantosDemétrio Antonio Gonçalves da S. GomesÉdson Cunha de Araújo JuniorElizabete das Chagas VilanovaGeorgina Costa TeixeiraGraciete Helena Nascimento dos SantosGuilherme Augusto Guerra AvelarIara Elce Lopes BarrosJaqueline Polon AbboudJeane Cristina Antas LinsJoanne Thalita Pereira SilvaKelma H. Aguiar de LucenaLara Wanderley Paes BarbosaLia Ferreira Caixeta Barreto de SiqueiraLuciana de Melo Freitas CarneiroLucila NagataMárcia de Oliveira Pereira LúcioMaria Cleane Rodrigues da SilvaMaria da Conceição Ribeiro SimõesMaria Fernanda da Mota MagalhãesMariana Viana AlmeidaMichelle Regina Faria LiraNádia Martins de Paula SouzaRafael Martins PapaRafael Ribeiro MatosRenata Porto PinheiroRoberta Souza dos AnjosSuelen Miranda de JesusTedy Roger Flores YnturiasValéria Cristina GonçalvesViviane Resende de Abreu CaetanoAbstract: This study aimed to describe the severity of abortion-related complications, factors associated with complications, the types of management and the experience of care in Brazil. A cross-sectional study in twenty hospitals (10 in Federal District, 3 in Rondônia and 7 in Maranhão). For 3 months, all women treated for abortion/miscarriage had their data collected. The severity of complications was defined according to World Health Organization criteria. Women with hemorrhage, infection or organs injury were invited to answer an interview about experience of care. Statistical analysis was performed using chi-square test and Poisson regression models. Among 1,683 women included, 82.5% had mild complications, 13.6% had moderate complications, 3.2% had potentially life-threatening conditions (PLTC) and 0.7% had severe maternal outcomes (SMO). Most women (94.2%) required uterine evacuation. Among these, 91.5% required surgical evacuation (with or without the use of uterotonics) and 8.5% used only uterotonics. The most frequent surgical evacuation method was curettage (66.9%), followed by manual vacuum aspiration (MVA) (32.3%). Factors associated with PLTC/SMO vs mild complications were having a gestational age ≥ 13 weeks (pravlence ratio - PR = 3.09; 95% confidence interval - 95%CI: 1.42-6.72), having been treated in Maranhão (PR = 0.27; 95%CI: 0.12-0.63) and in Rondônia (PR = 0.64; 95%CI: 0.20-0.99). Factors associated with moderate vs. mild complications were expulsion of products of conception before arrival to health facility (PR = 2.55; 95%CI: 1.64-3.96) and having been treated in Maranhão (PR = 0.58; 95%CI: 0.38-0.87). Most women who responded to the interview were treated kindly (95.6%), however, 66.7% felt stressed and 10.1% reported that their preferences were not respected during hospitalization. Nine out of ten women treated in Brazilian public hospitals due to abortion-related complications undergo some surgical procedure, the most common of which is uterine curettage. Approximately four in every hundred women experience severe complications. It is essential to ensure the supply of equipment for MVA and to encourage continuing medical education programs to increase the awareness of healthcare professionals about safer treatments for uterine evacuation.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2024001001414&lng=en&tlng=enAbortionInduced AbortionIncomplete AbortionMissed AbortionSeptic Abortion |
| spellingShingle | Nelio Neves Veiga Junior Luiz Francisco Cintra Baccaro Adriana Mendonça da Silva Alexandrino Alexandre Volta Andrade do Nascimento Camila Tereza Camilo Clerot Cintya Andreia do Nascimento Santos Claudia Lucrécia de Matos Silva Claudio Lucio de Medeiros Albuquerque Débora Paulo Santos Demétrio Antonio Gonçalves da S. Gomes Édson Cunha de Araújo Junior Elizabete das Chagas Vilanova Georgina Costa Teixeira Graciete Helena Nascimento dos Santos Guilherme Augusto Guerra Avelar Iara Elce Lopes Barros Jaqueline Polon Abboud Jeane Cristina Antas Lins Joanne Thalita Pereira Silva Kelma H. Aguiar de Lucena Lara Wanderley Paes Barbosa Lia Ferreira Caixeta Barreto de Siqueira Luciana de Melo Freitas Carneiro Lucila Nagata Márcia de Oliveira Pereira Lúcio Maria Cleane Rodrigues da Silva Maria da Conceição Ribeiro Simões Maria Fernanda da Mota Magalhães Mariana Viana Almeida Michelle Regina Faria Lira Nádia Martins de Paula Souza Rafael Martins Papa Rafael Ribeiro Matos Renata Porto Pinheiro Roberta Souza dos Anjos Suelen Miranda de Jesus Tedy Roger Flores Ynturias Valéria Cristina Gonçalves Viviane Resende de Abreu Caetano Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) Cadernos de Saúde Pública Abortion Induced Abortion Incomplete Abortion Missed Abortion Septic Abortion |
| title | Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) |
| title_full | Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) |
| title_fullStr | Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) |
| title_full_unstemmed | Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) |
| title_short | Abortion-related complications in Brazil: results from the World Health Organization Multi-country Survey on Abortion (MCS-A) |
| title_sort | abortion related complications in brazil results from the world health organization multi country survey on abortion mcs a |
| topic | Abortion Induced Abortion Incomplete Abortion Missed Abortion Septic Abortion |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2024001001414&lng=en&tlng=en |
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