Septic Abortion

ByAparna Sridhar, MD, UCLA Health
Reviewed/Revised Jan 2024
VIEW PROFESSIONAL VERSION

Septic abortion is a serious infection of the uterus that occurs shortly before, during, or after an abortion or a miscarriage. Septic abortion is a medical emergency.

  • Septic abortion causes chills, fever, vaginal discharge, vaginal bleeding, and a rapid heart rate, typically within 2 days after an abortion or a miscarriage.

  • Risk of septic abortion is high if a woman has a procedure done by an untrained person and/or without using sterile techniques or appropriate instruments to remove the contents of the uterus for an abortion or miscarriage.

  • A pelvic examination is done; blood cultures are done to identify the microorganisms causing the infection and thus help doctors choose the appropriate antibiotics.

  • Pregnancy tissue in the uterus must be removed as soon as possible; the infection is treated with antibiotics.

Septic abortion is possible after any procedure for abortion or a miscarriage. However, it occurs most often when an untrained person (or the pregnant woman herself) does the procedure without using sterile techniques and/or having appropriate surgical equipment. Healthcare professionals who are not trained to do pregnancy-related procedures or other untrained people may puncture the uterus during the procedure, and this may cause the infection to spread or cause heavy bleeding or injury to other organs, such as the intestines. These circumstances usually arise when lack of access to health care or personal issues prevent women from receiving safe and professional medical care.

Septic abortion may develop when pregnancy tissue remains in the uterus after an abortion or a miscarriage and becomes infected. Septic abortion is a medical emergency and can result in serious problems or death in a pregnant woman.

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. The cervix may dilate, and a miscarriage, if one has not already occurred, is possible. If the uterus is punctured during an abortion, women usually have severe abdominal pain.

In women who have a septic abortion, delirium may develop, and blood pressure may become dangerously low, resulting in septic shock.

Diagnosis of Septic Abortion

  • A doctor's evaluation

  • 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

If septic abortion seems likely, doctors send a sample of blood to a laboratory to be cultured (placed in a substance that encourages microorganisms to grow). This technique helps doctors identify the microorganism causing the infection and thus determine which antibiotics would be effective.

Ultrasonography is done to check for fragments from the pregnancy that may remain in the uterus.

Treatment of Septic Abortion

  • Antibiotics

  • Removal of pregnancy tissue from the uterus

surgical evacuation, using dilation and curettage [D & C] or dilation and evacuation [D & E]).

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