Medical Interruption of Pregnancy in the Second Trimester at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF): About 25 Cases

Introduction: Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. Objective: To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). Methodology: This was a retrospective and descriptive study conducted at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, i.e. a period of 9 years. All patients who underwent a medical termination of pregnancy during the study period and whose term of pregnancy was <28 weeks of amenorrhea were included in this study. Information was collected on a survey sheet from the patients’ clinical records, admission and hospitalisation registers, referral forms and operative report registers. Data were entered and analyzed using Excel, World and epi-info 7.2.2. The main variables studied were hospital frequency, diagnostic means, main indications, means of evacuation and maternal prognosis. Result: 25 patients were identified and represented 0.5% of deliveries. Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical ultrasound was performed in 100% of patients. These ultrasounds allowed us to determine fetal vitality and to find some fetal malformations (28%) and some anomalies in the fetal appendages (48%). Clinical examination alone was used to diagnose 24% of indications. In 68% of cases, the clinical examination and ultrasound were used to establish the indication. The most commonly used evacuation technique was medication in 88% of cases. Caesarean section was chosen for urgent cases in 12%. Uterine haemorrhage and post-abortion endometritis were the main complications. Conclusion: Medical termination of pregnancy is a delicate subject requiring multidisciplinary management. This series has allowed us to highlight our singularities, and will allow us to improve the management of our patients, in the prevention of haemorrhage and other complications.

Human Rights Jurisprudence in Hospice Care——Thoughts on the Concept and Boundary of “Death with Dignity”

Death with dignity is the embodiment of the dignity of human life in the context of end-of-life medical care.However,in the development of its concept,it has been alienated into a single way of death and is often confused with the concept of euthanasia.It is therefore a theoretical and practical necessity to re-expand the connotations of death with dignity Death with dignity is the subjective value of dignity reflected in the context of dying.It takes equality,freedom,and virtue as the core,and uses the right to life as its external support.It is projected onto the medical context and incorporates the patient’s right to informed consent.Subject to public interest,legal paternalism,and the principles of public order and good customs,the boundary of the right to death with dignity should be between active treatment and natural death,and active euthanasia in the form of giving up the right to life should not be included in the right to death with dignity.