Management of Septic Chemical Abortion with Renal Failure

Abstract

The woman with complications of chemical abortion is a prototype of the critically ill surgical patient whose survival can be expected only with careful management. The usual mortality when hysterectomy is not done, or delayed, is 60 per cent. We have recently cared for five such patients, all with sepsis and uterine necrosis. All were treated by hysterectomy. All had renal failure, four required dialysis and one underwent diuresis after injection of ethacrynic acid. The major complications, in addition to renal failure, were pulmonary. No pulmonary complications occurred in two patients who had prophylactic vena-cava clips and ligation of the ovarian veins. All patients survived without physiologic disturbances.