Retrospective Study Incidence and Management of Various Types of Spontaneous Abortion at Tertiary Care Hospital

Introduction: Spontaneous abortion refers to the loss of a non-viable fetus, managed through medical or surgical interventions following WHO guidelines to ensure safety under skilled healthcare providers. Despite legal access to abortion under the MTP Act of 1971 in India, a significant number of procedures remain unsafe due to factors such as limited awareness and poverty. This study explores the medical, social, and ethical aspects of abortion, emphasizing the importance of safe practices and targeted interventions to improve maternal health outcomes. Materials and Methods: This retrospective analytical study was conducted from April 2023 to March 2024 at M.P. Shah Government Medical College and GG Government Hospital, Jamnagar, Gujarat. The study included 1,126 patients who experienced spontaneous abortions, with data collected retrospectively from medical records. A comprehensive evaluation was carried out, including patient medical histories, physical examinations, and laboratory tests. Abortion procedures included suction evacuation or other medical methods aligned with WHO guidelines. Post-abortion care involved patient monitoring, antibiotics, and follow-up visits. Statistical analysis was performed to assess the demographic characteristics and treatment outcomes. Results: Among the 1,126 participants, the majority were aged 26-30 years (42.3%) and resided in urban areas (65.3%). Most were married (98.6%) and either had primary education (28.4%) or were illiterate (26.6%). The distribution of gestational age showed that 32.0% of abortions occurred before 8 weeks, 46.3% between 8-12 weeks, and 21.7% between 12-20 weeks. Incomplete abortions were the most frequent (46.62%), followed by complete abortions (19.53%) and missed abortions (15.6%), with septic abortions being rare (0.4%). The most common symptoms were spotting (36.8%) and bleeding per vaginum (55.2%), prompting antenatal visits. Anemia was the most prevalent complication (31.54%), while 8.0% of patients had pregnancy-induced hypertension (PIH). Progesterone vaginal pessary was the most common prophylaxis used for inevitable abortions (63.5%). Primary management methods included medical treatment (35.5%) and evacuation and curettage (43.1%). Conclusion: The findings emphasize the importance of improving prenatal care and raising awareness about safe abortion practices, especially for urban women aged 26-30 years. Effective management of incomplete abortions and addressing common complications like anemia and PIH are essential for enhancing maternal health outcomes.