Septic Abortion ✅
Related Subjects:
|Ectopic Pregnancy
| Ovarian Torsion
| Ruptured Ovarian Cyst
| Septic Abortion /Miscarriage
| Pelvic Abscess
| Acute Uterine Haemorrhage
| Pelvic Inflammatory Disease
⚠️ Septic abortion is a life-threatening infection following incomplete abortion (spontaneous or induced) or retained products of conception. Prompt recognition and aggressive management are essential to prevent sepsis, multi-organ failure, and death.
📋 Clinical Presentation
- Fever, chills, and rigors.
- Lower abdominal or pelvic pain and tenderness.
- Foul-smelling vaginal discharge or bleeding.
- Systemic signs of sepsis: tachycardia, hypotension, confusion, oliguria.
- History may include:
- Recent miscarriage or abortion (spontaneous or induced)
- Incomplete evacuation of products of conception
🔬 Investigations
- Laboratory:
- Full blood count → leukocytosis or neutrophilia
- Blood cultures → guide targeted antibiotic therapy
- CRP, renal and liver function → assess systemic involvement
- Imaging:
- Pelvic ultrasound → retained products, uterine enlargement, free fluid
- Other: Urinalysis if urinary tract involvement suspected
⚙️ Management
- Immediate Stabilisation:
- IV fluids to correct hypovolemia
- Monitor vital signs and urine output
- Oxygen therapy if hypoxic
- Antibiotic Therapy:
- Empirical broad-spectrum IV antibiotics (NICE recommendation):
- Gentamicin + Clindamycin ± Ampicillin
- Adjust based on cultures and clinical response
- Surgical Management:
- Dilation and curettage (D&C) or suction evacuation to remove retained products
- Hysterectomy only in severe, uncontrolled infection or uterine necrosis
- Supportive Care:
- Vasopressors if septic shock persists after fluid resuscitation
- Analgesia and monitoring for complications (e.g., septic emboli)
- Follow-up:
- Repeat ultrasound to ensure complete evacuation
- Counselling regarding future pregnancy planning and contraception
📚 References
