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pubmed:otherAbstract |
PIP: A mortality of 22% is reported for 50 cases of septic abortion complicated by hypotension. Patients were treated by a variety of medical managements, and 44 underwent surgery. 38% were subjected to hysterectomy based on the following indications: 1) unresponsive septic, hypotension, large uterus; 2) intrauterine douche with necrosis; and 3) anuria. Experience with this series indicated the following procedural principles: 1) hourly recording of blood pressure and urinary output; 2) gram-stained smears from cervix; 3) infusion of intravenous fluids and antibiotics geared to combat gram-negative organisms and Clostridium welchii (vasopressor may be required for patients in deep shock); and 4) surgical treatment to remove the source of infection and toxicity. Rationale for clinical management is discussed.
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