Septic Abortion

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Description

It is an abortion complicated with infections.

Signs and Symptoms

• Abdominal pain following history of abortion
• Fever may be present
• Foul smelling PV discharge which may be mixed with blood. 
• May be in shock or/and jaundiced
• Tender uterus, there may be rebound tenderness
• Cervix is usually open

Investigations

• FBC/DC
• Endocervical and/or Blood culture
• Group and X-match
• Ultrasound
• Bedside clotting time

Treatment

Supportive

• Apply ABCD principles of resuscitation
• Give IV RL/NS 3 liters or more in the first hour
• Give blood transfusion if indicated
• Insert an indwelling urethral catheter
• If an incomplete septic abortion perform necessary resuscitative measures and give IV antibiotics, allow at least 6 hours post antibiotic treatment before evacuation

Pharmacological Treatment

• Cefriaxone 1g IV 12 hourly for at least 5 days
• PLUS
• Metronidazole IV 500mg 8 hourly for at least 5 days
• Refer patient to hospital accompanied by a
• Patient Education, Counsel and provide appropriate contraception.