Septic abortion is a threatening uterine infection during, just before or after an abortion.
Septic abortions often caused by introduced abortions that are performed by inexperienced doctors using non-sterile methods, and are very common in illegal abortions. An infection occurs less often after a spontaneous abortion (spontaneous abortion).
Septic abortion is a threatening uterine infection during, just before or after an abortion. Septic abortions often caused by introduced abortions that are performed by inexperienced doctors using non-sterile methods, and are very common in illegal abortions. An infection occurs less often after a spontaneous abortion (spontaneous abortion). Typical causative pathogens are Escherichia coli, Enterobacter aerogenes, Proteus vulgaris, hemolytic streptococci, staphylococci and some anaerobic pathogens (eg. B. Clostridium perfringens). One or more organisms may be involved. Symptoms and signs Symptoms typically appear within 24 to 48 hours after the abortion and are similar to those of an inflammatory pelvic disease (pelvic inflammatory disease, PID) (z. B. chills, fever, vaginal discharge, and often signs of peritonitis) and often those of an impending or incomplete abortion (z. B. vaginal bleeding, cervical dilatation, disposal of pregnancy material). A perforation of the uterus during the procedure causes severe abdominal pain usually. There may septic shock with hypothermia, hypotension, oliguria and shortness of breath. Sepsis by C. perfringens may result in thrombocytopenia, ecchymosis and findings of intravascular hemolysis (z. B. anuria, anemia, jaundice, hemoglobinuria, hemosiderinuria). Diagnosis Clinical Investigation cultures to determine the antibiotic therapy ultrasonography Septic abortion is clinically usually obvious, usually by detection of serious infections in pregnant women. An ultrasound should be performed to check for pregnancy impacted products as a possible cause. A uterine perforation is most evident during the process; they should be suspected in women with unexplained severe abdominal pain and peritonitis. Ultrasound no perforation can be seen. In cases of suspected septic abortion aerobic and anaerobic blood cultures are created to define a specific antibiotic therapy. Laboratory tests should include complete blood counts, liver function tests, electrolyte levels, glucose, blood urea nitrogen and creatinine. PT and PTT are determined when the liver values ??are flashy or women have massive bleeding. Intensive treatment of antibiotic therapy (eg. B. Clindamycin plus gentamicin, with or without ampicillin) emptying of the uterus The treatment consists of an intensive antibiotic therapy and as quickly as possible emptying of the uterus. A typical antibiotic regimen is clindamycin 900 mg iv every 8 hours plus gentamicin 5 mg / kg i.v. 1 time / day with or without ampicillin 2 g iv all 4 hours. Alternatively, a combination of ampicillin, gentamycin and metronidazole 500 mg i.v. every 8 hours may be used.