Septic shock can affect anyone susceptible to germs that cause infection. When linked with abortion, septic shock can be a dangerous complication.
Abortion with septic shock is a medical emergency. An abortion is a procedure that ends a pregnancy. Septic shock occurs when your body has a life threatening reaction to an infection.
Types of abortions
There are several types of abortions:
- Spontaneous abortion: Also called a miscarriage, a spontaneous abortion 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.
- Surgical abortion: A surgical abortion is the removal of the fetus and placenta from the uterus, usually in the second trimester. A doctor typically uses a vacuum to extract the pregnancy tissue. The procedure is typically completed within 20 minutes.
- Medical abortion: A medical abortion uses prescribed medications for pregnancies in the first trimester to 10 weeks. These medications help pass the fetus and related tissue. The result may take up to 24 hours and is like a miscarriage.
- Self-induced abortion: A self-induced abortion is done by the gestational parent. This term includes abortions done with legal, over-the-counter medications 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 occurs after an abortion when your body gets a bacterial infection.
In most cases, the infection stays in a specific area. In severe cases, the infection enters your bloodstream and travels throughout your body. This is called a systemic (whole body) 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 — your blood pressure drops dangerously low and treatment is not working.
In abortions, two main factors can contribute to the onset of sepsis and septic shock. They are:
- an incomplete abortion, when 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 shock is an uncommon abortion complication in the United States. Research estimates the total rate of abortion complications is
Your risk of septic shock increases when bacteria are more likely to enter your bloodstream. Having any surgery or medical procedure
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 of infection.
In a surgical abortion, a doctor uses a vacuum with a hollow tube to remove the fetus and placenta from the uterus. Medical devices, such as catheters, drainage tubes, or breathing tubes, can put you at a similar risk of infection.
The risk of septic shock is
In addition, having certain underlying conditions before an abortion can make you more susceptible to septic shock. These conditions include diabetes or a weakened immune system.
Most medical abortion regimens recommend a follow-up ultrasound after the procedure. This follow-up can help determine if any pregnancy material remains and help prevent sepsis.
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 from loss of blood)
In cases when a septic abortion causes septic shock, 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 taken and tested for bacteria. Tissue samples from wounds may be tested too.
- CT scans can show residual pregnancy tissue, obstructions, perforations, or foreign bodies.
- A chest X-ray can show fluid in your lungs or pneumonia.
- An electrocardiogram (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 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 fine-tuned once the bacteria are identified. Your chances of surviving septic shock increase when you take antibiotics as soon as possible.
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)
Surgery is needed in some cases. A doctor may recommend a complete hysterectomy if the infection is caused by tissues from an abortion.
In some cases, your 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 a doctor suspects the infection is caused by:
Septic shock has a high risk of death. A person’s outlook can improve based on:
- overall health
- degree of organ failure
- timing of the start of medical treatment
Many cases of septic shock can’t be prevented. But you can reduce your risk by taking these precautions:
- Talk with 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.