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