Septic abortion is manifested by fever, malodorous vaginal discharge, pelvic and abdominal pain, and cervical motion tenderness. Peritonitis and sepsis may be seen. Trauma to the cervix or upper vagina may be recognized if there has been a criminal abortion.
A complete blood count, urinalysis, endometrial cultures, blood cultures, chest x-ray, and abdominal x-ray to rule out uterine perforation should be obtained. Ultrasound may be helpful in ruling out retained products of conception.
Treatment of septic abortion involves hospitalization and intravenous antibiotic therapy. Selection of antibiotic agents should provide for both anaerobic and aerobic coverage. A D&C should be done, and a hysterectomy may have to be performed if the infection does not respond to treatment.
Revision date: July 3, 2011
Last revised: by Sebastian Scheller, MD, ScD