Introduction Abortion-related complications are a significant cause of morbidity and mortality among women in many Latin American and Caribbean (LAC) countries. The objective of this study was to characterise abortion-related complication severity, describe the management of these complications and report women’s experiences with abortion care in selected countries of the Americas region. Methods This is a cross-sectional study of 70 health facilities across six countries in the region. We collected data on women’s characteristics including socio-demographics, obstetric history, clinical information, management procedures and using Audio Computer-Assisted Self-Interviewing (ACASI) survey the experience of abortion care. Descriptive bivariate analysis was performed for women’s characteristics, management of complications and reported experiences of abortion care by severity of complications, organised in five hierarchical mutually exclusive categories based on indicators present at assessment. Generalised linear estimation models were used to assess the association between women’s characteristics and severity of complications. Results We collected data on 7983 women with abortion-related complications. Complications were classified as mild (46.3%), moderate (49.5%), potentially life-threatening (3.1%), near-miss cases (1.1%) and deaths (0.2%). Being single, having a gestational age of ≥13 weeks and having expelled products of conception before arrival at the facility were significantly associated with experiencing severe maternal outcomes compared with mild complications. Management of abortion-related complications included both uterotonics and uterine evacuation for two-thirds of the women while one-third received uterine evacuation only. Surgical uterine evacuation was performed in 93.2% (7437/7983) of women, being vacuum aspiration the most common one (5007/7437, 67.4%). Of the 327 women who completed the ACASI survey, 16.5% reported having an induced abortion, 12.5% of the women stated that they were not given explanations regarding their care nor were able to ask questions during their examination and treatment with percentages increasing with the severity of morbidity. Conclusions This is one of the first studies using a standardised methodology to measure severity of abortion-related complications and women’s experiences with abortion care in LAC. Results aim to inform policies and programmes addressing sexual and reproductive rights and health in the region. Data are available upon request. The data used for this analysis might be made available upon reasonable request, in accordance with the WHO/HRP MCS-A Research Group data sharing policy and WHO Policy of Data Use and Data Sharing. For further information, contact srhmph@who.int and srhpua@who.int.

中文翻译：

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六个拉丁美洲和加勒比国家的堕胎相关发病率：WHO/HRP 多国堕胎调查 (MCS-A) 的结果

简介 在许多拉丁美洲和加勒比 (LAC) 国家，与堕胎相关的并发症是女性发病率和死亡率的重要原因。本研究的目的是描述流产相关并发症的严重程度，描述这些并发症的管理，并报告美洲地区选定国家妇女的流产护理经验。方法 这是对该地区六个国家的 70 家医疗机构的横断面研究。我们收集了关于女性特征的数据，包括社会人口统计学、产科病史、临床信息、管理程序和使用音频计算机辅助自我访谈 (ACASI) 调查堕胎护理的经验。对女性特征进行描述性双变量分析，并发症的管理和按并发症严重程度报告的流产护理经验，根据评估中出现的指标分为五个相互排斥的分层类别。广义线性估计模型用于评估女性特征与并发症严重程度之间的关联。结果 我们收集了 7983 名患有流产相关并发症的妇女的数据。并发症分为轻度 (46.3%)、中度 (49.5%)、可能危及生命 (3.1%)、未遂病例 (1.1%) 和死亡 (0.2%)。与轻度并发症相比，单身、胎龄≥13 周和在到达机构之前排出受孕产物与经历严重的孕产妇结局显着相关。对流产相关并发症的管理包括对三分之二的女性进行子宫收缩剂和清宫，而三分之一仅接受了清宫。93.2% (7437/7983) 的女性进行了手术清宫，其中最常见的是负压吸引术 (5007/7437, 67.4%)。在完成 ACAI 调查的 327 名女性中，16.5% 的女性报告有人工流产，12.5% 的女性表示她们在检查和治疗过程中没有得到有关护理的解释，也无法提出问题，百分比随着严重程度的增加而增加的发病率。结论 这是最早使用标准化方法来衡量 LAC 中流产相关并发症的严重程度和女性流产护理经验的研究之一。结果旨在为解决该地区性和生殖权利及健康的政策和计划提供信息。可根据要求提供数据。根据 WHO/HRP MCS-A 研究组数据共享政策和 WHO 数据使用和数据共享政策，可应合理要求提供用于该分析的数据。如需更多信息，请联系 srhmph@who.int 和 srhpua@who.int。