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By ULY CLINIC

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Septic Abortion

 

Introduction

 

It is an abortion complicated with infections.  

 

Diagnostic Criteria

 

  • 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  

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Management of septic abortion in dispensary & health centre

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  • Apply ABCD principles of resuscitation 

  • Give IV RL/NS 3liters or more in the first hour 

  • Insert an indwelling urethral catheter 

  • Obtain blood for Hb 

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Pharmacological Treatment  

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  • Ampicillin 1g IV 6 hourly  for 24–48 hours   

AND   

  • Metronidazole IV 500mg 8 hourly for 24–48 hours   

AND  

  • Gentamicin 80mg IV 12 hourly for 7 days

 

Referral:

 

Refer patient to hospital with an escort of a nurse.  

 

Management in the Hospital:

  • Full Blood Count? (FBC)

  • Give blood transfusion if indicated 

  • Perform endocervical swab for culture and sensitivity

  • Evacuate the uterus with sharp wide curette under general anesthesia 

 

Pharmacological Treatment

 

Treat as above and when the patient is stable continue with;    

  • Amoxicillin 500mg 6 hourly for 7 days    

  • Metronidazole (PO) 400mg 8 hourly for 7 days  

 

If no response with the above antibiotics within 3 days; 

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Adjust according to culture and sensitivity results. if no culture sensitivity services switch to    

  • Ceftriaxone IV 1g 12 hourly for 5 days     

AND            

  • FeFol one tablet twice a day for 3 months and review after every 4 weeks

 

Patient Education

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Counsel and provide appropriate contraception.

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Updated on, 3.11.2020

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References

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1. STG

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