Septic abortion
Encyclopedia
A septic abortion or septic miscarriage is a form of miscarriage
that is associated with a serious uterine infection. The infection carries risk of spreading infection to other parts of the body and cause septicaemia, a grave risk to the life of the woman.
. Also, sexually transmitted infections (STI) such as chlamydia may also cause septic abortion.
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
(DIC). 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.
and legal abortion (to prevent unsafe abortion
s) have dramatically reduced the number of septic abortions. To decrease 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 provider immediately.
intravenous antibiotics should be given until the fever is gone.
A dilatation and curettage (D&C) may be needed to clean the uterus of any residual tissue. An Rh negative blood should be given an injection of Rh immune globulin, unless the father is also known to be Rh negative. In cases so severe that abscess
es 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 use tampons should be avoided until recommended by the healthcare provider.
Miscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...
that is associated with a serious uterine infection. The infection carries risk of spreading infection to other parts of the body and cause septicaemia, a grave risk to the life of the woman.
Causes
A septic abortion can occur when bacteria enters the uterus. The bacteria may also belong to the vaginal floraVaginal flora
The bacteria that colonize the vagina, collectively referred to as the vaginal microbiome, were discovered by the German gynecologist Albert Döderlein in 1892. The amount and type of bacteria present have significant implications for a woman's overall health...
. Also, sexually transmitted infections (STI) such as chlamydia may also cause septic abortion.
Symptoms
In a woman with septic abortion, symptoms that are related to the infection are mainly:- High fever, usually above 101 °FFahrenheitFahrenheit is the temperature scale proposed in 1724 by, and named after, the German physicist Daniel Gabriel Fahrenheit . Within this scale, the freezing of water into ice is defined at 32 degrees, while the boiling point of water is defined to be 212 degrees...
- Chills
- Severe abdominal pain and/or cramping
- Prolonged or heavy vaginal bleedingVaginal bleedingVaginal bleeding refers to bleeding in females that is either a physiologic response during the non-conceptional menstrual cycle or caused by hormonal or organic problems of the reproductive system. Vaginal bleeding may occur at any age, but always needs investigation when encountered in female...
- Foul-smelling vaginal dischargeVaginal dischargeVaginal discharge is term given to biological fluids contained within or expelled from the vagina.While most discharge is normal and can reflect the various stages of a woman's cycle, some discharge can be a result of an infection, such as a sexually transmitted disease.The term blennorrhea is...
- Backache
A cold or urinary tract infection
Urinary tract infection
A urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...
may mimic many of the symptoms.
As the condition becomes more serious, signs of septic shock
Septic shock
Septic shock is a medical emergency caused by decreased tissue perfusion and oxygen delivery as a result of severe infection and sepsis, though the microbe may be systemic or localized to a particular site. It can cause multiple organ dysfunction syndrome and death...
may appear, including:
- Low blood pressure (hypotensionHypotensionIn physiology and medicine, hypotension is abnormally low blood pressure, especially in the arteries of the systemic circulation. It is best understood as a physiologic state, rather than a disease. It is often associated with shock, though not necessarily indicative of it. Hypotension is the...
) - Low body temperature (hypothermiaHypothermiaHypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as . Body temperature is usually maintained near a constant level of through biologic homeostasis or thermoregulation...
) - Little or no urine output (oliguriaOliguriaOliguria is the low output of urine, It is clinically classified as an output below 300-500ml/day. The decreased output of urine may be a sign of dehydration, renal failure, hypovolemic shock, HHNS Hyperosmolar Hyperglycemic Nonketotic Syndrome, multiple organ dysfunction syndrome, urinary...
) - Respiratory distress (dyspneaDyspneaDyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...
and labored breathingLabored breathingLabored respiration or labored breathing is an abnormal respiration characterized by evidence of increased effort to breathe, including the use of accessory muscles of respiration, stridor, grunting, or nasal flaring.-Classification:...
)
Septic shock may lead to kidney failure, bleeding diathesis
Bleeding diathesis
In medicine , bleeding diathesis is an unusual susceptibility to bleeding mostly due to hypocoagulability, in turn caused by a coagulopathy . Several types are distinguished, ranging from mild to lethal...
, and disseminated intravascular coagulation
Disseminated intravascular coagulation
Disseminated intravascular coagulation , also known as disseminated intravascular coagulopathy or consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of small blood clots inside the blood...
(DIC). 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.
Risk factors
The risk of a septic abortion is increased by mainly the following factors:- The fetal membranesFetal membranesThe fetal membranes, or chorioamniotic membranes, are the amnion and chorion which surround and protect a developing fetus....
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
- Unsafe abortionUnsafe abortionAn unsafe abortion is the termination of an unwanted pregnancy by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both...
was made to end the pregnancy - Insertion of tools, chemicals, or soaps into the uterus
- RU-486 was used for a medical abortion
Prevention
Better birth controlBirth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
and legal abortion (to prevent unsafe abortion
Unsafe abortion
An unsafe abortion is the termination of an unwanted pregnancy by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both...
s) have dramatically reduced the number of septic abortions. To decrease 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 provider immediately.
Treatment
The woman should have intravenous fluids to maintain blood pressure and urine output. Broad-spectrumBroad-spectrum antibiotic
The term broad-spectrum antibiotic refers to an antibiotic that acts against a wide range of disease-causing bacteria. A broad-spectrum antibiotic acts against both Gram-positive and Gram-negative bacteria, in contrast to a narrow-spectrum antibiotic, which is effective against specific families of...
intravenous antibiotics should be given until the fever is gone.
A dilatation and curettage (D&C) may be needed to clean the uterus of any residual tissue. An Rh negative blood should be given an injection of Rh immune globulin, unless the father is also known to be Rh negative. In cases so severe that abscess
Abscess
An abscess is a collection of pus that has accumulated in a cavity formed by the tissue in which the pus resides due to an infectious process or other foreign materials...
es have formed in the ovaries and tubes, it may be necessary to remove the uterus by hysterectomy
Hysterectomy
A hysterectomy is the surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy may be total or partial...
, 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
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
or use tampons should be avoided until recommended by the healthcare provider.