Résumé : The Colombian Federation of Societies of Obstetrics and Gynecology coordinated this prospective 4-nation study of abortion morbidity and mortality in 36 health facilities. Data were gathered in March-September 1990 from 5 facilities in Bolivia, 15 in Colombia, 6 in Peru, and 10 in Venezuela. 8871 of the 14,501 abortions occurring in the 36 facilities were analyzed. There were 12,382 deliveries and 948 abortions in the Bolivian facilities, 46,012 deliveries and 4930 abortions in Colombia, 16,962 deliveries and 2305 abortions in Peru, and 38,358 deliveries and 6268 abortions in Venezuela. In the 36 facilities there were 113,714 deliveries and 14,501 abortions; 12.75% of pregnancies ended in abortion. The proportions ending in abortion were 7.6% in Bolivia, 10.7% in Colombia, 13.1% in Peru, and 16.3% in Venezuela. Of the 8871 cases analyzed, 783 were in Bolivia, 4263 in Colombia, 1933 in Peru, and 1892 in Venezuela. 13.5% of the women were under 20, 27.4% were 20-24, and 25.7% were 25-29. The average age was 27.0 years. 4.0% were illiterate, 16.1% had incomplete primary and 12.8% had complete primary educations, and 56.0% had incomplete secondary educations. The average woman had had 6.95 years of schooling. 20.5% were pregnant for the 1st time. The average number of previous pregnancies was 2.48. 69.8% had no previous history of abortion. The average number of previous abortions was .43. 78.9% were in stable unions. 52.0% stated that the current pregnancy was desired and 42.9% that it was not. 51.8% of the women stated they wanted more children and 41.6% that they did not. 69.6% did not use a contraceptive method, 9.5% used less effective methods, and 15.5% used highly effective methods at the time they became pregnant. The abortions occurred at 10 weeks or less in 46.1% of cases and at 11 weeks or more in 48.4%. The average gestational age was 11.15 weeks. 75.6% of the abortions were classified as incomplete and 15.2% as septic at admission. 83.1% of the septic abortions were classified as endometritis, with the infection considered advanced in 16.9% 85.1% of abortions were classified as spontaneous and 11.6% as induced. 803 women (9.05%) had complications on admission, including 589 with excessive bleeding and 52 with uterine perforation. 94.8% of cases were treated by curettage, under general anesthesia in 65.5% of cases. A transfusion was necessary in 521 cases (5.9%). 43 also had hysterectomies. There were 36 deaths in the 8871 cases analyzed, for a rate of 406 per 100,000. The rates were 53/100,000 in Venezuela, 310 in Peru, 493 in Colombia, and 1022 in Bolivia. Only 36.6% of the women had a prescription for contraception on discharge. 22 of the deaths were in pregnancies of over 11 weeks, 25 were classified as incomplete abortions, and 27 were septic on admission.
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