Treating Spontaneous and Induced Septic Abortions
- 1 May 2015
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 125 (5), 1042-1048
- https://doi.org/10.1097/aog.0000000000000795
Abstract
Worldwide, abortion accounts for approximately 14% of pregnancy-related deaths, and septic abortion is a major cause of the deaths from abortion. Today, septic abortion is an uncommon event in the United States. The most critical treatment of septic abortion remains the prompt removal of infected tissue. Antibiotic administration and fluid resuscitation provide necessary secondary levels of treatment. Most young physicians have never treated septic abortion. Many obstetrician-gynecologists experience, or plan to experience, global health activities and will likely care for women with septic abortion. Thus, updated knowledge of the pathophysiology, clinical presentation, microbes, and proper treatment is needed to optimally treat this emergency condition when it exists. The pathophysiology of septic abortion involves infection of the placenta, especially the maternal villous space that leads to a high frequency of bacteremia. Symptoms and signs range from mild to severe. The microbes involved are usually common vaginal bacteria, including anaerobes, but occasionally potentially very serious and lethal infection is caused by bacteria that produce toxins. The primary treatment is early curettage to remove infected and devitalized tissue even in the face of continued fetal heart tones. Important secondary treatments are the administration of fluids and antibiotics. Updated references of sepsis and septic shock are reviewed.Keywords
This publication has 33 references indexed in Scilit:
- Unsafe abortion and postabortion care - an overviewActa Obstetricia et Gynecologica Scandinavica, 2011
- Are antibiotics necessary after 48 hours of improvement in infected/septic abortions? A randomized controlled trial followed by a cohort studyAmerican Journal of Obstetrics and Gynecology, 2011
- Abortion-related mortality in a tertiary medical centre in Enugu, NigeriaJournal of Obstetrics and Gynaecology, 2007
- Acute Renal Failure and SepsisThe New England Journal of Medicine, 2004
- Risk Factors for Legal Induced Abortion–Related Mortality in the United StatesObstetrics & Gynecology, 2004
- Complicated induced abortion in Sagamu, NigeriaJournal of Obstetrics and Gynaecology, 2002
- The Acute Respiratory Distress SyndromeThe New England Journal of Medicine, 2000
- Disseminated Intravascular CoagulationThe New England Journal of Medicine, 1999
- Clindamycin-Induced Suppression of Toxic-Shock Syndrome-Associated Exotoxin ProductionThe Journal of Infectious Diseases, 1984
- A Double-Blind Comparison of Clindamycin with Penicillin plus Chloramphenicol in Treatment of Septic AbortionThe Journal of Infectious Diseases, 1977