Septic Abortion Flashcards
Signs of septic abortion?
- Uterine bleeding/spotted in the first trimester
- Infection signs - Fever, WBC >10,500
- Abdominal tenderness, cervical motion tenderness,
- foul-smelling vaginal discharge
Any type of abortion associated with uterine infection
Organisms responsible for septic abortion?
Organisms less likely to be isolated?
Polymicrobial – anaerobic strep, Bacteriodies, E. coli, GBS
Clostridium perfringens, H influenza, Campylobacter
Mechanism for infection in septic abortion?
Ascending infection from the vagina to cervix to endometrium to myometrium to parametrium to peritoneum
Treatment of septic abortion?
- Maintain blood pressure
- Monitor blood pressure, O2 sat, urine output
- Start antibiotics (gentamicin + clindamycin)
Antibiotic regimens for septic abortion?
- Gentamicin + clindamycin
- Cephalosporins OR penicillins + beta-lactamase inhibitors
- Metronidazole + ampicillin + aminoglycoside
Timing of curettage?
Four hours after antibiotics are begun
Why observe urine output?
Oligoria is early sign of septic shock
Patient with antibiotic treated septic abortion – CT scan shows pocket of air in muscle. Tx?
Necrotizing metritis – hysterectomy needed