A septic abortion is an abortion associated with an infection inside a pregnant woman's uterus. An abortion is the expulsion of the unborn child and placenta from a woman's uterus.
What is going on in the body?
The uterus of a pregnant woman is normally protected by a plug of mucus in the cervix, as well as the membranes surrounding the unborn child. A septic abortion can occur when bacteria enter the uterus through the mucus plug. These bacteria can be introduced by unclean tools used during an elective abortion. The bacteria may also be those that normally live in a woman's vagina.
If the woman has a sexually transmitted infection (STI) such as chlamydia, the bacteria causing the infection can spread through the unborn child or placenta, to the lining of the uterus. It may go into the muscles of the uterus or beyond that to other nearby organs. If the infection reaches the bloodstream, it is called sepsis.
What are the causes and risks of the condition?
A septic abortion may be caused by any of the following factors:
the membranes surrounding the unborn child have ruptured, sometimes without being detected
the woman has a sexually transmitted infection, such as chlamydia
an intrauterine device (IUD) was left in place during the pregnancy
tissue from the unborn child or placenta is left inside the uterus after a miscarriage or abortion
attempts were made to end the pregnancy, often illegally, by inserting tools, chemicals, or soaps into the uterus
- RU-486 was used for a medical abortion
What can be done to prevent the condition?
Better birth control and legal abortion have dramatically reduced the number of septic abortions. To cut the risk further, a woman should be tested for common sexually transmitted infections in the first trimester of her pregnancy. If a woman thinks she might be miscarrying or has miscarried, she should call her healthcare professional immediately. It may be too late to save the pregnancy, but good follow-up care can prevent an infection.
How is the condition diagnosed?
A septic abortion is diagnosed when a woman has a temperature of at least 101 F, plus other signs and symptoms of the condition. Other reasons for the fever, such as a cold or urinary tract infection, must be ruled out. As a result, a physical exam and pelvic exam will be done.
The healthcare professional may order diagnostic tests, including the following:
a CBC, or complete blood count, to look for signs of infection
a pregnancy ultrasound, which may show an unborn child that has died, or an empty sac in the uterus
- cultures of blood or uterine contents, to check for the presence of bacteria that cause an infection
Long Term Effects
What are the long-term effects of the condition?
Shock may lead to kidney failure, general bleeding, and clotting problems that can be hard to control. A septic abortion can cause death if it is not treated promptly and effectively.
If the infection spreads to the abdomen, intestinal organs may also become infected. That can cause scar tissue leading to chronic pain, intestinal blockage, and infertility.
What are the risks to others?
A septic abortion is not contagious and poses no risk to others. However, the abortion itself causes the death of the unborn child.
What are the treatments for the condition?
Immediate and aggressive treatment in a hospital is necessary to avoid serious complications of septic abortion. The woman should have intravenous (IV) fluids to maintain blood pressure and urine output. IV antibiotics will be given to cover a range of bacteria until the fever is gone.
A dilatation and curettage (D&C) may be needed to clean out the uterus if tissue has remained inside it. A woman with Rh negative blood will be given an injection of Rh immune globulin, unless the father is also known to have Rh negative blood. In cases so severe that abscesses have formed in the ovaries and tubes, it may be necessary to remove the uterus and the infected organs.
What are the side effects of the treatments?
Antibiotics may cause rash, upset stomach, or allergic reaction. Surgery can be complicated by bleeding, further infection, or a reaction to anesthetic.
What happens after treatment for the condition?
Following a septic abortion, a woman may be tired for several weeks. Taking vitamins with iron once a day will restore the woman's iron stores, and may result in the more rapid return of a normal energy level. She should not have intercourse or use tampons until recommended by the healthcare professional.
If another pregnancy is desired, a couple should wait three to six months after treatment is successfully completed to try to conceive. If they are not successful within a year, a test may done to see if the fallopian tubes were damaged by the infection. A woman should be alert to signs of depression. If she does become depressed, counseling or antidepressant medications can help.
How is the condition monitored?
Any new or worsening symptoms should be reported to the healthcare professional.