Septic Abortion

Overview

A septic abortion is a serious infection of the uterus and nearby tissues that occurs in connection with a miscarriage or abortion. It can develop when bacteria infect pregnancy tissue remaining in the uterus, such as after an incomplete abortion or an unsafe procedure. The infection can spread and, if not treated quickly, can progress to sepsis, a life-threatening, body-wide response to infection.

A septic abortion is a medical emergency. Anyone with fever, severe pelvic pain, or foul-smelling discharge during or after a pregnancy loss should seek emergency care immediately. With prompt antibiotics, removal of infected tissue, and supportive treatment, the infection can usually be controlled, but delay can be dangerous.

The infection typically begins in the uterus and can spread to the surrounding pelvic organs and, in severe cases, into the bloodstream. This is why early recognition and treatment are so important. Access to safe, qualified care for miscarriage and pregnancy termination, together with prompt treatment of retained tissue, greatly reduces the risk of this complication.

Symptoms

Symptoms reflect infection in and around the uterus and, as it advances, throughout the body.

• Fever and chills
• Severe lower abdominal or pelvic pain and tenderness
• Foul-smelling vaginal discharge or bleeding
• A rapid heartbeat
• Feeling very unwell, weak, or confused
• Low blood pressure, dizziness, or fainting in severe cases

These symptoms, especially fever and foul-smelling discharge during or after a pregnancy loss, are warning signs of a dangerous infection and require emergency evaluation without delay.

Causes

Septic abortion is caused by bacterial infection in the setting of a pregnancy loss.

• Retained tissue: Pregnancy tissue left in the uterus can become infected.
• Unsafe procedures: Pregnancy terminations performed in unsterile conditions carry a high risk of infection.
• Pre-existing infection: Infection in the reproductive tract that spreads during a loss.

The infection often involves several types of bacteria normally found in the vaginal or bowel area, which can spread into the uterus and beyond.

Risk Factors

• An incomplete miscarriage with retained tissue
• An abortion performed in unsafe or unsterile conditions
• Existing sexually transmitted or pelvic infections
• Delayed treatment of a miscarriage or retained tissue
• Instruments or objects introduced into the uterus in unsafe procedures

Diagnosis

Because it is an emergency, diagnosis and treatment proceed together. Steps include:

• Examination: Checking for fever, a tender uterus, and the source of infection.
• Blood tests: To assess infection, blood count, and organ function.
• Cultures: Of blood and the genital tract to identify bacteria.
• Ultrasound: To look for retained pregnancy tissue or collections of pus.

Because the situation is urgent, treatment with fluids and antibiotics often begins before all test results are available, guided by the clinical picture. Identifying and removing the source of infection, usually retained pregnancy tissue, is a central part of getting the infection under control.

Treatment

Septic abortion is treated urgently in hospital. Treatment usually combines:

• Antibiotics: Strong intravenous antibiotics started promptly to fight the infection.
• Removing infected tissue: A procedure to empty the uterus of retained pregnancy tissue, which is the source of infection.
• Supportive care: Fluids and close monitoring, and intensive care if sepsis develops.
• Surgery: In severe cases that do not respond, additional surgery may be needed.

Fast treatment greatly improves the outcome, which is why recognizing the warning signs and seeking emergency care quickly is so important. Once the infection is controlled and the source removed, most people recover, though the length of recovery depends on how advanced the infection was. The care team will also discuss follow-up and, when relevant, future pregnancy.

Prevention

• Seek prompt medical care during a miscarriage so retained tissue can be detected and managed
• Ensure any pregnancy termination is performed by qualified providers in safe, sterile conditions
• Treat reproductive tract infections promptly
• Attend follow-up after a pregnancy loss to confirm the uterus has emptied
• Report fever, severe pain, or foul discharge urgently

When to See a Doctor

Septic abortion is a medical emergency. Call emergency services or go to an emergency department immediately if, during or after a pregnancy loss, you have:

• Fever or chills
• Severe lower abdominal or pelvic pain
• Foul-smelling vaginal discharge or bleeding
• A racing heart, confusion, dizziness, or fainting
• Feeling severely unwell

Do not wait, as the infection can worsen rapidly and become life-threatening.

Related Topics

Frequently Asked Questions

References

1. World Health Organization (WHO). Complications of abortion and infection.
2. MedlinePlus, U.S. National Library of Medicine. Sepsis.
3. American College of Obstetricians and Gynecologists (ACOG). Early pregnancy loss.
4. Centers for Disease Control and Prevention (CDC). Sepsis.