Post Miscarriage Sepsis

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Pyrexia in a woman who has delivered or miscarried in the previous 6 weeks may be due to puerperal or post miscarriage sepsis and should be managed actively. Abdominal pain in addition to pyrexia is strongly suggestive. The uterus may need evacuation. Suction curettage or manual vacuum aspiration are safer than sharp curettage and are the recommended first line procedures.

Note: Every year a few women die because of what is thought to be post­ miscarriage sepsis when in reality it is fever from malaria causing abortion. Post-miscarriage sepsis will need a laparotomy and evacuation of uterus if the patient does not respond to antibiotic therapy.

Mild/moderate sepsis:

	Medicine	Adult Dose	Frequency	Duration
	amoxicillin po	500mg	3 times a day	10 days
or	ciprofloxacin po	500mg	2 times a day	10 days
and	metronidazole po	400mg	3 times a day	10 days
and	doxycycline po	100mg	2 times a day	10 days