Prevalence and factors associated with second trimester pregnancy loss among women admitted at a National Referral Hospital in Uganda: a cross-sectional study.

Abstract

Background: Second trimester pregnancy loss (abortion) refers to induced or spontaneous termination of pregnancy from 13 to the end of 26 weeks of gestation. Second trimester abortions contribute to a high proportion of maternal morbidity, mortality and psychological stress especially in low-resource countries with restricted access to safe abortion services. While globally, the prevalence of second trimester abortions is 10-15%, the prevalence at Kawempe National Referral Hospital was not known. The study objective 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 235 women with abortions admitted at Kawempe National Referral Hospital. Quantitative data was collected using a structured interviewer administered questionnaire. Bivariate and multivariate analysis was done using STATA version 14. The Student's T- test was used to check for association between the dependent and independent variables.

Results: The prevalence of second trimester abortion was 41.7%.|Factors associated with second trimester abortion were; being 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), malaria infection confirmed by a rapid test (aPR = 2.5, 95% CI= 1.75 - 3.54), no prior history of abortion (aPR = 1.5, 95% CI =1.04 - 2.27) and no condom use in the previous 1 year (aPR = 1.6, 95% CI =1.11 - 2.23).

Conclusion: The prevalence of second trimester abortion was higher than the global estimates. Service providers should actively screen pregnant women for HIV, urinary tract infection, malaria and then offer effective treatment accordingly. The Ministry of Health should develop and disseminate protocols and standard management guidelines for case management of second trimester abortions.