Septic abortion


A septic abortion "is an infection of the placenta and fetus of a previable pregnancy. Infection is centered in the placenta and there is risk of spreading to the uterus, causing pelvic infection or becoming systemic to cause sepsis and potential damage of distant vital organs."

Signs and symptoms

In a woman with septic abortion, signs and symptoms that are related to the infection are mainly:
A cold or urinary tract infection may mimic many of the symptoms.
As the condition becomes more serious, signs of septic shock may appear, including:
Septic shock may lead to kidney failure, bleeding diathesis, and disseminated intravascular coagulation. Intestinal organs may also become infected, potentially causing scar tissue with chronic pain, intestinal blockage, and infertility.
If the septic abortion is not treated quickly and effectively, the woman may die.

Causes

Septic abortion is often a complication of an infection of the upper genital tract by multiple strains of gram positive and/or gram negative bacteria. Septic abortion can occur when these bacteria enter the uterus or even when the natural vaginal flora becomes pathogenic. Also, sexually transmitted infections such as chlamydia may cause septic abortion.

Risk factors

The risk of a septic abortion is increased by mainly the following factors:
The woman should have intravenous fluids to maintain blood pressure and urine output. Broad-spectrum intravenous antibiotics should be given until the fever is gone. There are different antibiotic regimens which are almost equal such as intravenous clindamycin, penicillin plus chloramphenicol, cephalothin plus kanamycin. And only one research found that tetracycline is more effective to decrease the time of fever than penicillin G. However, new studies are needed to establish the most effective antibiotic in septic abortion.
A dilatation and curettage or misoprostol may be needed to clean the uterus of any residual tissue. Rh negative blood should be given to the patient in addition to an injection of Rh immune globulin, unless the father is also known to be Rh negative. In cases so severe that abscesses have formed in the ovaries and tubes, it may be necessary to remove the uterus by hysterectomy, and possibly other infected organs as well.
After successful treatment of a septic abortion, a woman may be tired for several weeks. In case of substantial bleeding, iron supplementation may be helpful. Sexual intercourse or the use of tampons should be avoided until recommended by the healthcare provider.