Abortion with septic shock is a medical emergency. An abortion is a procedure that ends a pregnancy. Septic shock occurs when an infection overtakes your body and causes very low blood pressure.
Septic shock can affect anyone susceptible to the germs that cause infection. When linked with abortion, septic shock can be a dangerous complication.
Types of abortions
There are several types of abortions:
- A spontaneous abortion (miscarriage) occurs when pregnancy tissue is passed from the body. There are technically two types of spontaneous abortions: “complete,” in which all the pregnancy tissue is passed and no intervention is needed, and “incomplete,” in which only part of the pregnancy tissue is passed and it usually does require intervention.
- A surgical abortion is the removal of the fetus and placenta from the woman’s uterus. The doctor typically uses a vacuum to extract the pregnancy material.
- A medical abortion uses prescribed medications. These medications help the mother pass the fetus and related tissue. The result is similar to a miscarriage.
- A self-induced abortion is done by the mother herself. This term includes both abortions conducted through legal, over-the-counter medication and those performed through unregulated, often dangerous methods.
Septic shock is a medical emergency. If you recently had an abortion and experience any of the following symptoms, seek medical help immediately:
- very high or very low body temperature
- heavy bleeding
- severe pain
- cool, pale arms and legs
- feelings of confusion, restlessness, or fatigue
- shaking chills
- low blood pressure, especially when standing
- inability to urinate
- heart palpitations
- rapid, pounding heart rate
- difficult, rapid breathing with shortness of breath
Septic shock often occurs after the abortion procedure is completed. It strikes when your body becomes contaminated with a bacterial infection.
In most cases, the infection stays in a specific area. However, in more severe cases, the infection enters your bloodstream and travels throughout your body. This is called a systemic reaction. The resulting condition is called sepsis.
Your body’s initial reaction to sepsis typically involves very low or very high body temperatures. In addition, sepsis causes:
- rapid heart rate
- rapid breathing rate
- very high or very low white blood cell count
As sepsis weakens your body’s immune responses, your organs begin to fail. When sepsis worsens so that your blood pressure drops dangerously low and is immune to treatment, the condition is called septic shock.
In abortions, two main factors can contribute to the onset of sepsis and ultimately, septic shock. They are:
- an incomplete abortion: pieces of the pregnancy tissue remain in the body after a spontaneous or induced abortion, both medical and surgical
- bacterial infection in the uterus during a surgical or self-induced abortion
Your risk for septic shock is increased in situations where bacteria are more likely to enter your bloodstream. Having any surgery or medical procedure puts you at an increased risk for septic shock.
When medical devices are inserted into your body, the device can introduce bacteria. This makes infection and sepsis more likely. The longer the device is in your body, the higher your risk for infection.
In a surgical abortion, the doctor uses a vacuum with a hollow tube to remove the fetus and placenta from the womb. Medical devices, such as catheters, drainage tubes, or breathing tubes can put you at a similar risk of infection.
The risk for septic shock is significantly increased in self-induced abortion, where medical instruments are not used. There is less ability to prevent germs from spreading because many of the common tools are everyday household items and are not sterile.
In addition, having certain underlying conditions prior to an abortion can make you more susceptible to septic shock. They include having a chronic condition such as diabetes or a weakened immune system.
Most medical abortion regimens recommend a follow-up ultrasound after the abortion has occurred. This examination can help determine if any of the pregnancy materials remain.
If not treated promptly, septic shock can be fatal. It can cause organ failure and damage virtually any part of your body.
Typical complications include:
- respiratory failure
- cardiac failure
- liver failure
- kidney failure
- gangrene (body tissues die due to loss of blood)
In cases where septic shock is caused by a septic abortion, a total hysterectomy may be necessary to remove the source of the infection. A total hysterectomy removes the uterus, cervix, fallopian tubes, and both ovaries.
A diagnosis of septic shock can be confirmed with laboratory tests:
- A blood test can identify bacteria in the bloodstream. Your white blood count, blood oxygen level, and organ functions will also be checked.
- Samples from your urine, cerebrospinal fluid, and lung mucus will be cultured and tested for bacteria. Tissue samples from wounds may be tested.
- CT scans may be performed to identify residual pregnancy matter, obstructions, perforations, or foreign bodies.
- A chest X-ray may be done to check for fluid in your lungs or pneumonia.
- An electrocardiogram (ECG or EKG) may be done to identify abnormal heart rhythms. An EKG monitors your heart rate. Electrodes are taped to your chest to send the sound of your heart to the monitor. This can help determine whether the heart’s blood supply is affected.
Treatment and recovery
Septic shock is a medical emergency that must be treated immediately. Because of the urgency, treatment often begins before the test results can confirm the diagnosis. If you have signs of septic shock after an abortion, you must be admitted immediately to an intensive care unit.
Successful treatment for septic shock is centered on two goals: protection of the vital organs and removal of the source of the infection.
Antibiotics are given first. Test results identifying the specific bacteria that are causing sepsis can take a few days. To improve the chances of killing the bacteria, two or three antibiotics may be combined. Typical antibiotic treatment involves a combination of:
- clindamycin or metronidazole
The treatment can be refined once the specific bacteria are identified. Your chances of surviving septic shock increase when you receive antibiotics soon after the abortion.
Your treatment may include:
- mechanical ventilation (breathing machine)
- medication (to increase blood pressure)
- intravenous (IV) fluids (to increase fluid in the bloodstream and blood pressure)
- hemodynamic monitoring (evaluation of heart and lung pressure levels)
In some cases, surgery is necessary. A complete hysterectomy may be performed if the infection is caused by matter from an abortion.
In some cases, a laparotomy may be performed. A laparotomy is an incision in the abdominal wall that allows for quick access to the abdominal cavity. This may be needed if your physician suspects the infection is caused by:
- uterine perforation
- bowel injury
- soft tissue infection
Septic shock, regardless of the source, has a high mortality (death) rate. Specific circumstances can affect successful treatment. These include:
- overall health
- degree of organ failure
- timing of the start of medical treatment
Many cases of septic shock can’t be anticipated or prevented. You can reduce your risk by following these precautions:
- Consult with a licensed physician or clinic to pursue an elective abortion.
- Follow the directions exactly as provided for a medical abortion.
- Never attempt a self-induced abortion.
- Be aware of the signs of bacterial infection after any type of abortion.
- Pursue treatment for an infection as soon as possible.