Sexual and reproductive health in women undergoing mid-trimester pregnancy termination (MTPT) below 24 weeks of gestational age (GA) in a single obstetric unit in Singapore
Choo, S1; Huang, ZW1
1: NUH, Singapore
Objective: To evaluate sexually transmitted infections screening (STI) and contraceptive uptake in women undergoing mid-term pregnancy termination (MTPT) in a single obstetric unit in Singapore.
Materials and Methods: This retrospective cohort study included all women (n=87) who underwent MTPT for social reasons or fetal anomalies (FA) after 12weeks’ gestational age (GA) from December 2015-October 2017. Sociodemographic and obstetric data (e.g. ethnicities, marital status, parity, previous abortions, contraceptives uptake) were obtained from electronic medical records.
Results: 52% of women underwent MTPT for social reasons and they were younger than women undergoing MTPT for FA (28.2±8 years versus 33.8±5 years, p<0.01). 41.3% of women who underwent MTPT for social reasons were single, with women of Malay ethnicity (41.3%) forming the majority. 36.9% had previous abortions and only one woman had prior contraceptive usage. 82.6% of these MTPTs occurred before 20 weeks’ GA. STI screening was performed in 15.2% of women undergoing MTPT for social reasons. In contrast, women who performed MTPT for FA were older; almost all were married, with women of Chinese ethnicity forming 50% of this cohort. None of the women undergoing MTPT for FA had STI screening and only one woman took up contraception post abortion. In women who underwent MTPT for social reasons, 65.2% took up contraception and none chose barrier contraception.
Conclusion: Women who underwent MTPT for social reasons were more likely to be single, younger, of Malay ethnicity and had previous abortions. The low uptake of contraception with no usage of barrier contraceptives and low rates of STI screening in these women are concerning. These women are at higher risks of STIs and pelvic infections given the higher chances of previous abortions. It is imperative that regular STI screening, use of barrier contraceptives in addition to effective contraception usage to avoid unplanned pregnancies must be emphasized in these women to ensure the well -being of their sexual and reproductive health.
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