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 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 passes from the body. There are two types of spontaneous abortion: “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 usually requires intervention.
- A surgical abortion is the removal of the fetus and placenta from a woman’s uterus. The doctor typically uses a vacuum to extract the pregnancy material.
- A medical abortion uses prescribed medications. These medications help a woman pass the fetus and related tissue. The result is like a miscarriage.
- A self-induced abortion is done by the mother. This term includes abortions done with legal, over-the-counter medication and those performed using 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 right away:
- 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 an abortion. It strikes when your body gets a bacterial infection.
In most cases, the infection stays in a specific area. However, in 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:
As sepsis weakens your body’s immune responses, your organs begin to fail. The condition is called septic shock when sepsis worsens so that your blood pressure drops dangerously low and is immune to treatment.
In abortions, two main factors can contribute to the onset of sepsis and septic shock. They are:
- an incomplete abortion: pieces of 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
Septic abortion is uncommon in the US. The National Center for Biotechnology Information (NCBI) reports the complication rate is
A medical device, when inserted into your body, 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 when medical instruments are not used. There is less ability to prevent germs from spreading because many of the tools used are everyday household items and not sterile.
In addition, having certain underlying conditions before 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. This examination can help determine if any of the pregnancy material remains.
Septic shock can be fatal if not treated promptly. It can cause organ failure and damage 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 infection. A total hysterectomy removes the uterus, cervix, fallopian tubes, and both ovaries.
A doctor can confirm a diagnosis of septic shock with laboratory tests:
- Blood tests can identify bacteria in the bloodstream. Your white blood cell 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 can show residual pregnancy matter, obstructions, perforations, or foreign bodies.
- A chest X-ray can show fluid in your lungs or pneumonia.
- An electrocardiogram (ECG or EKG) can uncover 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.
Septic shock is a medical emergency that must be treated immediately. Because of the urgency, treatment often begins before test results confirm the diagnosis. If you have symptoms of septic shock after an abortion, you must be admitted to an intensive care unit right away.
Treatment for septic shock focuses on protecting vital organs and removing of the source of infection.
Antibiotics are given first. Test results identifying the specific bacteria 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:
Treatment can be refined once the 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. You doctor may recommend a complete hysterectomy if the infection is caused by matter from an abortion.
In some cases, you doctor may perform a laparotomy. 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 has a high mortality (death) rate. Circumstances that can affect successful treatment include:
- overall health
- degree of organ failure
- timing of the start of medical treatment
Many cases of septic shock can’t be prevented. You can reduce your risk by taking these precautions:
- Consult a doctor about an elective abortion.
- Follow the directions exactly as provided for a medical abortion.
- Never attempt a self-induced abortion.
- Be aware of the symptoms of bacterial infection after any type of abortion.
- Get treatment for an infection as soon as possible.