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.
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.
A woman with a septic abortion is seriously ill, with the following symptoms that are related to the infection: high fever, usually above 101 degrees Fchillssevere abdominal pain or crampingprolonged or heavy vaginal bleedingfoul-smelling vaginal dischargebackache
As the condition becomes more serious, signs of shock may appear. These include: low blood pressurelow body temperaturelittle or no urine outputtrouble breathing
If the septic abortion is not treated quickly and effectively, the woman may die.
A septic abortion may be caused by any of the following factors: the membranes surrounding the unborn child have ruptured, sometimes without being detectedthe woman has a sexually transmitted infection, such as chlamydiaan intrauterine device (IUD) was left in place during the pregnancytissue from the unborn child or placenta is left inside the uterus after a miscarriage or abortionattempts were made to end the pregnancy, often illegally, by inserting tools, chemicals, or soaps into the uterusRU-486 was used for a medical abortion
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.
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 infectiona pregnancy ultrasound, which may show an unborn child that has died, or an empty sac in the uteruscultures of blood or uterine contents, to check for the presence of bacteria that cause an infection
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.
A septic abortion is not contagious and poses no risk to others. However, the abortion itself causes the death of the unborn child.
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.
Antibiotics may cause rash, upset stomach, or allergic reaction. Surgery can be complicated by bleeding, further infection, or a reaction to anesthetic.
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.
Any new or worsening symptoms should be reported to the healthcare professional.