Abstract
Background: Unsafe abortion is a major problem in Uganda, being one of the leading causes of maternal morbidity and mortality. An estimated 297,000 unsafe abortions are performed yearly, with an abortion rate of 54 per 1,000 women aged 15-49; nearly 85,000 women have been treated annually for complications of unsafe abortion, leading to about 1,200 deaths. Abortions are performed mostly under unsafe conditions, by people without medical training. In rural areas in northern Uganda, women often resort to traditional providers, who use local herbs as abortion remedies. Little is known about the biological properties of these herbs and their toxicity profile.
Case presentation : Here we present the case series of two women, of 31 and 24 years of age, who underwent unsafe abortion for unintended pregnancy by using herbal medicines, i.e. Commelina Africana (wandering jew) and Vernonia amygdalina (bitter leaf) respectively. While the first case resulted in uterine necrosis and pelvic peritonitis, which required multiple surgical interventions and the use of reserve antibiotics, the second case resulted in liver and renal failure that led to the death of the patient.
Conclusion: This case series describes the unusual severe toxicity of two herbal medicines that are frequently used to induce abortion in Northern Uganda. It highlights possible associations ofCommelina Africana (wandering jew) with uterine necrosis complicated by pyometra and sepsis, and of Vernonia amygdalina(bitter leaf) with acute liver failure and renal failure.
Keywords: Unsafe abortion, herbal medicines, herbs, northern Uganda, case series