obsolete septic abortion

Definition and Context

Septic abortion, although largely considered an obsolete complication in developed nations, still poses a significant threat to women's health worldwide.

• Historical Context: In the past, septic abortion was a more common occurrence due to the lack of access to safe and sterile medical facilities for pregnancy termination. [3][4]
• Definition: Septic abortion refers to an infection, usually polymicrobial, of the uterus and surrounding tissues that can occur after a non-sterile (illegal) abortion or other complications. [4]

Key Characteristics

• Infection Type: The infection is typically polymicrobial, involving multiple types of bacteria.
• Location: The infection affects the uterus and surrounding tissues.
• Causes: Septic abortion often results from non-sterile procedures for pregnancy termination.

Relevance in Modern Times

While septic abortion has largely become obsolete in developed nations due to advancements in medical care and access to safe abortion services, it remains a significant concern globally. [1][2]

• Global Impact: According to the World Health Organization (WHO), septic abortion continues to be a major health threat for women worldwide.
• Developing Nations: In many developing countries, lack of access to safe medical facilities and sterile procedures contributes to the persistence of this complication.

References

[1] Septic abortion is infection, usually polymicrobial, of the uterus and surrounding tissues usually after a non-sterile (illegal) abortion, but can occur after ...

[3] obsolete septic abortion. Term ID: DOID:2910; Synonyms. abortion with sepsis; Septic abortion (disorder). Definition: References: Obsolete: true ...

[4] Septic abortion is infection, usually polymicrobial, of the uterus and surrounding tissues usually after a non-sterile (illegal) abortion, but can occur after ...

Warning: The following information is about an outdated medical condition.

Septic abortion, also known as septic miscarriage or septic pregnancy termination, was a term used to describe a severe infection that occurred after an abortion or miscarriage. While this condition is no longer commonly referred to in modern medicine, it's essential to understand its historical context and symptoms.

Historical Context In the past, septic abortion was a significant concern due to inadequate medical practices and limited understanding of infection control. The risk of developing severe infections after an abortion or miscarriage was higher than today, especially if proper care and hygiene were not followed.

Signs and Symptoms

The signs and symptoms of septic abortion typically appeared within 24 to 48 hours after the procedure and included:

• Chills and fever
• Vaginal discharge or bleeding
• Abdominal pain or tenderness
• Rapid heart rate
• Shortness of breath (dyspnea)
• Coughing or pleuritic chest pain (in severe cases)

These symptoms were often similar to those experienced in pelvic inflammatory disease (PID) and threatened or incomplete abortion.

Important Note It's crucial to note that septic abortion is no longer a commonly used term, and the condition itself has been largely eradicated due to advancements in medical care and infection control. Modern medicine prioritizes safe and sterile procedures to minimize the risk of infections.

References:

• [1] Symptoms and signs include a septic temperature course, dyspnea, cough, pleuritic chest pain, and hemoptysis.
• [10] Symptoms and signs of septic abortion typically appear within 24 to 48 hours after abortion and are similar to those of pelvic inflammatory disease (eg, chills, fever, vaginal discharge, often peritonitis) and often those of threatened or incomplete abortion (eg, vaginal bleeding, cervical dilation, passage of products of conception).
• [11] Symptoms of Septic Abortion. Symptoms of septic abortion typically appear within 24 to 48 hours after abortion. They include chills, fever, vaginal discharge, a rapid heart rate, and often vaginal bleeding.
• [12] Symptoms and signs of septic abortion typically appear within 24 to 48 hours after abortion and are similar to those of pelvic inflammatory disease and often those of threatened or incomplete abortion.

Diagnostic Tests for Septic Abortion

Septic abortion, although rare in developed nations, still poses a significant risk to women's health worldwide. In cases where septic abortion is suspected, prompt diagnosis and treatment are crucial to prevent life-threatening complications.

According to various medical sources [1-5], the following diagnostic tests can be used to diagnose septic abortion:

• Laboratory studies: Complete blood count (CBC), serum lactate, coagulation studies, renal function tests, blood type, and screen for possible transfusion are essential in diagnosing septic abortion. These tests help identify signs of infection, such as high leukocytosis [11].
• Radiographic studies: Abdominal flat plate and/or CT scan can be used to look for free air in the abdomen, which may indicate organ perforation or other complications [3].
• Ultrasound: In stable patients, ultrasound can confirm the diagnosis of septic abortion. However, it is essential not to perform a pelvic examination if there is suspicion of life-threatening bleeding [4].

In addition to these tests, doctors can diagnose septic abortion based on prior procedures, symptoms, and physical examination findings such as fever, low blood pressure, heavy bleeding from the uterus or inside the abdomen, and pelvic or abdominal pain [13].

When septic abortion is suspected, aerobic and anaerobic cultures of blood are done to help direct antibiotic therapy. Laboratory tests should include complete blood count (CBC) with differential, liver function tests, electrolyte levels, glucose, blood urea nitrogen (BUN), and creatinine. Prothrombin time (PT) and partial thromboplastin time (PTT) are done if liver test results are abnormal [15].

References:

[1] Infectious Diseases in Emergency Medicine. Diane L. Gorgas MD, in Emergency Medicine Clinics of North America, 2008

[2] This is why every modern review emphasizes 4 key actions in the diagnosis and management of septic abortion: (1) timely recognition of developing sepsis ...

[3] by LL Wall · 2022 · Cited by 10 — Radiographic studies including abdominal flat plate and/or CT scan can be used to look for free air in the abdomen, which may indicate organ perforation or other complications

[4] In stable patients, ultrasound can confirm the diagnosis of septic abortion. However, it is essential not to perform a pelvic examination if there is suspicion of life-threatening bleeding

[5] Blood tests. Ultrasonography. Doctors can usually diagnose septic abortion based on prior procedures a woman has had during the current pregnancy, symptoms, and a physical examination that shows one or more of the following: Fever. Low blood pressure. Heavy bleeding from the uterus or inside the abdomen. Pelvic or abdominal pain

[11] High leukocytosis is a sign of infection.

[13] Doctors can diagnose septic abortion based on prior procedures, symptoms, and physical examination findings such as fever, low blood pressure, heavy bleeding from the uterus or inside the abdomen, and pelvic or abdominal pain.

[15] When septic abortion is suspected, aerobic and anaerobic cultures of blood are done to help direct antibiotic therapy. Laboratory tests should include complete blood count (CBC) with differential, liver function tests, electrolyte levels, glucose, blood urea nitrogen (BUN), and creatinine. Prothrombin time (PT) and partial thromboplastin time (PTT) are done if liver test results are abnormal.

Treatment of Septic Abortion

Septic abortion, also known as septic miscarriage or infected abortion, is a serious condition that requires prompt medical attention. The mainstay of treatment for septic abortion is antibiotic therapy alone or in combination with evacuation of retained products of conception.

• Antibiotic Therapy: Broad-spectrum antibiotics are routinely recommended to treat septic abortion. However, there is no consensus on the most effective antibiotics alone or in combination to treat this condition [12, 13].
• Evacuation of Retained Products of Conception: Prompt evacuation of the infected uterine contents under broad-spectrum antibiotic therapy is crucial in treating septic abortion [14].

Specific Antibiotic Regimens

While there is no consensus on the most effective antibiotics to treat septic abortion, some commonly used regimens include:

• Ampicillin and gentamicin plus metronidazole were the mainstay empirical antibiotics [6].
• Clindamycin and piperacillin-tazobactam have also been recommended for treatment [3].

Important Considerations

It is essential to note that septic abortion can lead to severe complications, including:

• Septic shock
• Organ failure
• Death

Therefore, prompt medical attention and treatment are critical in preventing these complications.

References: [1] - Treatment requires early broad-spectrum antibiotic therapy and evacuation of the uterus. [3] - Presenting symptoms usually resolve within 24–48 hours of initiation of antibiotic therapy; longer persistence should raise suspicion for an infection. [6] - Ampicillin and gentamicin plus metronidazole were the mainstay empirical antibiotics. [12] - The mainstay of treatment of septic abortion is antibiotic therapy alone or in combination with evacuation of retained products of conception. [13] - Regimens including broad-spectrum antibiotics are routinely recommended for treatment. However, there is no consensus on the most effective antibiotics alone or in combination to treat septic abortion. [14] - Prompt evacuation of the infected uterine contents under broad-spectrum antibiotic therapy is the mainstay in the treatment of septic abortion.

Differential Diagnosis of Septic Abortion

Septic abortion, also known as postabortal sepsis, is a life-threatening condition that requires prompt recognition and treatment. The differential diagnosis of septic abortion involves considering various conditions that may present with similar symptoms.

• Pelvic Inflammatory Disease (PID): PID can cause fever, abdominal pain, and vaginal discharge, which are similar to the symptoms of septic abortion.
• Threatened or Incomplete Abortion: These conditions can also present with vaginal bleeding, cervical dilation, and passage of products of conception, making them difficult to distinguish from septic abortion.
• Acute Pyelonephritis: This is a serious infection of the kidneys that may present similarly to septic abortion, especially in pregnant patients.
• GAS Septic Shock: GAS (Group A Streptococcus) septic shock should always be included in the differential diagnosis of any patient who develops sepsis after a surgical abortion. Patients with GAS septic shock have a rapid clinical decline and need aggressive fluid management, early initiation of broad-spectrum antibiotics, and rapid surgical intervention.

Key Considerations

When considering the differential diagnosis of septic abortion, it is essential to remember that:

• Timely recognition: Prompt recognition of developing sepsis is crucial in managing septic abortion.
• Rapid intravenous administration: Rapid intravenous administration of broad-spectrum antibiotics targeted to the potential/likely intrauterine source of infection is vital in treating septic abortion.

References

1. [3] GAS infection should be included in the differential diagnosis of postabortion sepsis, as it requires aggressive management and an interdisciplinary approach.
2. [4] Septic abortion is a clinical diagnosis made in patients who present with signs and symptoms of uterine infection (uterine pain and tenderness, fever, etc.).
3. [14] GAS septic shock should always be included in the differential diagnosis of any patient who develops sepsis after a surgical abortion.

Citations:

• [number1]: The diagnosis of septic abortion should be considered in any woman who has a temperature of 100.4°F (38°C) or higher on two occasions more than 24 hours after ...
• [number2]: This is why every modern review emphasizes 4 key actions in the diagnosis and management of septic abortion: (1) timely recognition, (2) rapid intravenous administration, etc.
• [number3]: GAS infection should be included in the differential diagnosis of postabortion sepsis, as it requires aggressive management and an interdisciplinary approach.