Prevalence and factors associated with second trimester abortion among women admitted at Kawempe National Referral Hospital

Abstract

Background: Globally, it is estimated that 10–15% of abortions happen in the second trimester. They contribute a higher proportion of morbidity and mortality with increased psychological and emotional distress especially in low-income countries like Uganda. The aim of this study was to determine the prevalence and factors associated with second trimester abortion at Kawempe National Referral Hospital.Methods: A hospital based cross-sectional study was conducted among women with abortion admitted at Kawempe National Referral Hospital. Two hundred thirty five participants were recruited consecutively after informed consent. Data was collected using interviewer administered questionnaire. The Data was entered Using Epi data version 4.2 and analysed with STATA version 14. Variables which had p-value < 0.2 at bivariate analysis, were entered into logistic regression to identify factors associated variables with a p-value of < 0.05 at the 95% CI were considered statistically significant. Results: The prevalence of second trimester abortion was 41.7%. Participants who had no prior history of abortion (aPR = 1.5, 95% CI =1.04 - 2.27), no condom use in the previous 1 year (aPR = 1.6, 95% CI =1.11 – 2.23), were HIV positive (aPR = 1.9, 95% CI =1.32 – 2.61), having a urinary tract infection (aPR = 1.9, 95% CI =1.30 – 2.72) and malaria infection confirmed by a rapid test (aPR = 2.5, 95% CI= 1.75 – 3.54) were more likely to have had second trimester abortion. Conclusions and recommendations: The prevalence of second trimester abortion was high. Having no prior history of abortion, no condom use in the previous 1 year, being HIV positive, having a urinary tract infection and lastly having malaria confirmed on a rapid diagnostic test were factors associated. We recommend that antenatal care providers in this setting should actively screen women for HIV, urinary tract infection, malaria and then offer effective treatment accordingly. MOH should develop and disseminate to clinicians a comprehensive protocol and standard management guidelines. A qualitative study is needed to expound on the factors associated and the coping strategies of participants following second trimester pregnancy loss in order to guide evidence-based and patient-centered clinical practice.