Infection in Pregnancy - Complications and Treatment of Septic Abortion

Infection in Pregnancy - Complications and Treatment of Septic Abortion

The ecstasy of being pregnant cannot be expressed in words. The moment a woman gets pregnant she starts harboring a new life inside her with utmost care and attention. But there are some unfortunate times where one has to unwillingly terminate the pregnancy following the life-threatening complications. Septic abortion is one such deadly complication that needs medical intervention without delay.

Abortion from Septic Shock

Septic shock is a life-threatening infection in which the blood pressure drops dramatically. The condition occurs due to bacterial and viral infection and is most commonly occurs in the people who are hospitalized for some surgical procedure.

A septic abortion is a condition that occurs following infection of the placenta and fetus. The infection is typically centered in the placenta but the risk of spreading it to the uterus and pelvis might cause damage to vital organs of the body. Septic shock in pregnant women will require medical emergency treatment without which the chances of dying become inevitable.

Symptoms Septic Abortion

Women who have recently undergone an abortion should check the following symptoms and seek emergency help as soon as possible:

  • Heavy vaginal bleeding
  • Very low or very high body temperature
  • Low blood pressure
  • Foul smelling vaginal discharge
  • Chills
  • Difficulty in urinating or little urine output
  • Severe abdominal pain
  • Backache or heavy pressure on the back
  • Difficulty breathing or shortness of breath
  • Heart palpitation and rapid heart rate

What Causes Abortion from Septic Shock?

Septic shock typically occurs after the completion of abortion procedure in a woman. It usually happens when the body gets infected with bacteria. In majority of the cases, the infection is limited to a specific area, however, in severe cases, the infection enters the bloodstream and spread throughout the body. This reaction is called systemic which can cause damage to vital organs of the body.

When sepsis progresses, the blood pressure drops to dangerously low levels which is sometimes difficult to treat. This results in septic shock. There are basically two main factors that are likely to increase the chances of sepsis and eventually, septic shock:

  • When remains of the fetus are left in the body after induced or spontaneous abortion, both surgically and medically. Infections occurring from spontaneous abortion (miscarriage) are less common.
  • Self-induced abortion causing bacterial infection in the uterus.

Complications of Septic Abortion

When sepsis strikes, the body’s initial reaction usually involves either very low or very high body temperature. Additionally, sepsis causes rapid breathing, rapid heart rate, and very high or very low white blood cells count. Gradually, sepsis can weaken your body’s immune system causing vital organs to fail.

If left untreated, sepsis leading to septic shock can be deadly. It can cause:

  • Kidney failure
  • Liver failure
  • Heart failure
  • Respiratory failure
  • Gangrene (death of body tissues due to interrupted blood supply)

In other cases where septic shock occurs due to septic abortion, a surgery (hysterectomy) might be needed to completely remove the source of infection. This includes removal of the uterus, fallopian tubes, cervix and both the ovaries.

Are there any risk factors related to septic abortion?

The risk of septic shock abortion increases when bacteria find a way to enter the bloodstream. These include:

  • The use of medical devices such as a catheter, breathing tubes and drainage tubes can introduce bacteria into the body.
  • Self-induced abortion where medical instrument is not used can make way for germs and bacteria into the body. This is because most of the tools are household items that are not sterile.
  • Chronic conditions such as diabetes or people with weak immune system are more vulnerable to septic shock.
  • Pregnancy residuals in the body after the abortion can increase the chances of infection.

Diagnosis of Septic Abortion

Diagnosis of septic shock abortion can be confirmed in lab tests. These include:

  • Blood test can confirm the presence of bacteria in the bloodstream. The doctor might check the blood oxygen level, blood count and proper functioning of the organs.
  • Urine samples, lung mucus and cerebrospinal fluid (colorless fluid found in brain and spinal cord) will also be tested. In addition, tissue samples will also be checked.
  • X-ray of the chest will be conducted to check for pneumonia or fluid in the lungs.
  • The doctor can also perform CT scan to check for remains of pregnancy, tear or holes during surgery (perforation) and any foreign matter.
  • An electrocardiogram (ECG) might also be conducted to check abnormal heart rhythms. This can also determine whether the blood supply to the heart is affected.

How Abortion from Septic Shock is Treated and Managed?

Woman suffering from septic shock after abortion should immediately be admitted to the emergency medical unit. Treatment typically begins even before the test results confirm the condition. The treatment is primarily focused on two things; removing the source of infection and protecting vital organs of the body.

  1. Initially, antibiotics are given. A combination of two-three anti-biotics might be given to increase the chances of killing the bacteria. If antibiotics are given soon after the abortion, the chances of survival are high.
  2. In severe cases, surgery is required where the focus lies on removing the source of infection
  3. At emergency unit:
    •     You might be placed on mechanical ventilator to improve breathing
    •     You would receive medication to improve blood pressure
    •     You would need oxygen supply
    •     You would get intravenous fluids to improve the blood pressure and fluid level in the bloodstream
    •     You might get intravenous antibiotics until the fever is gone
    •     You might be examined for lungs and heart pressure levels (hemodynamic monitoring)

After successful treatment, a woman might feel tired for several weeks. Additionally, the doctor might advise her to get iron supplements in case of substantial bleeding. Moreover, the woman might be ordered to avoid sexual intercourse and use of tampons (soft material that absorbs menstrual blood).

Prevention of Septic Abortion

Many of the cases occurring from septic shock can’t be predicted or anticipated. However, one can reduce the risk by following below precautions:

  • Go for an elective abortion performed by a qualified and licensed physician.
  • Do not attempt self-induced abortion.
  • Be alert for the signs and symptoms of infection after an abortion.
  • Seek for treatment of the infection as soon as possible.
  • Pregnant women should get tested for sexually transmitted diseases in the first trimester.
  • Most medical procedures of abortion are followed by ultrasound that checks for any pregnancy remains. Don’t forget to go through these tests after abortion.

Septic Abortion in India

Self-induced unsafe abortion cases are increasing day by day, especially in the developing countries like India. This is due to social stigma of premarital sex and extra-marital affairs that often results in unwanted pregnancies. This makes them perform a self-induced abortion which often results in septic abortion.

According to Medical Termination of Pregnancy Act, 1971, abortion is allowed only less than 20 weeks of pregnancy. But an exception to the act also allows abortion after 20 weeks if there is endangered to the life of the woman.

Septic abortion irrespective of the source has a high mortality rate. However, health, age, degree of organ failure and most importantly, timing of the treatment after septic abortion can contribute to successful treatment.