What Is Septic Abortion?
SEPTIC ABORTION
Description
Any abortion associated with fever and signs of pelvic or generalized sepsis is considered septic abortion. The infection carries risk of spreading infection to other parts of the body and cause sepsis, a grave risk to the life of the woman.
Causes
A septic abortion can occur due to bacterial infection of the uterus. Also, sexually transmitted infections (STI) such as chlamydia may cause septic abortion. Most septic abortions result from illegal abortions but sepsis may follow spontaneous and elective abortions.
Symptoms
Fever, tachycardia, abdominal distension and tenderness, pelvic tenderness, vaginal bleeding and foul smelling/purulent vaginal discharge are common symptoms of septic abortion. In severe cases, …show more content…
Treatment (to be managed at a tertiary care level)
1. Before starting antibiotic therapy, high vaginal or cervical swab and blood culture should be obtained.
2. IV fluids for correction of electrolyte imbalance (see section on Shock in Chapter 2).
3. Oxygen by facemask in severe cases. In cases of adult respiratory distress syndrome, intubation and ventilatory support is required, and hydrotherapy, if required.
4. If blood pressure is not controlled with fluid replacement, Inj. Dopamine infusion in 5% Dextrose 2-5 mcg/kg/min and dose titrated according to clinical and haemodynamic response (for details see section on Shock).
5. In case of shock, acidosis is corrected by IV Sodium bicarbonate 50-100 mEq in normal saline.
6. Inj. Ampicillin 2 g stat followed by 500 mg IV 6 hourly (after test dose).
7. Inj. Cefuroxime or Ceftazidime 1-2 g IV 2 times a day (after test dose).
8. Inj. Gentamicin 1.5 mg/kg then 1 mg/kg IV 8 hourly.
9. Inj. Amikacin 250-500 mg IV 8 hourly.
10. Inj. Metronidazole 500 mg IV 8
Description
Any abortion associated with fever and signs of pelvic or generalized sepsis is considered septic abortion. The infection carries risk of spreading infection to other parts of the body and cause sepsis, a grave risk to the life of the woman.
Causes
A septic abortion can occur due to bacterial infection of the uterus. Also, sexually transmitted infections (STI) such as chlamydia may cause septic abortion. Most septic abortions result from illegal abortions but sepsis may follow spontaneous and elective abortions.
Symptoms
Fever, tachycardia, abdominal distension and tenderness, pelvic tenderness, vaginal bleeding and foul smelling/purulent vaginal discharge are common symptoms of septic abortion. In severe cases, …show more content…
Treatment (to be managed at a tertiary care level)
1. Before starting antibiotic therapy, high vaginal or cervical swab and blood culture should be obtained.
2. IV fluids for correction of electrolyte imbalance (see section on Shock in Chapter 2).
3. Oxygen by facemask in severe cases. In cases of adult respiratory distress syndrome, intubation and ventilatory support is required, and hydrotherapy, if required.
4. If blood pressure is not controlled with fluid replacement, Inj. Dopamine infusion in 5% Dextrose 2-5 mcg/kg/min and dose titrated according to clinical and haemodynamic response (for details see section on Shock).
5. In case of shock, acidosis is corrected by IV Sodium bicarbonate 50-100 mEq in normal saline.
6. Inj. Ampicillin 2 g stat followed by 500 mg IV 6 hourly (after test dose).
7. Inj. Cefuroxime or Ceftazidime 1-2 g IV 2 times a day (after test dose).
8. Inj. Gentamicin 1.5 mg/kg then 1 mg/kg IV 8 hourly.
9. Inj. Amikacin 250-500 mg IV 8 hourly.
10. Inj. Metronidazole 500 mg IV 8