eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology

Abortion, Septic: Differential Diagnoses & Workup

Author: Slava V Gaufberg, MD, Assistant Professor of Medicine, Harvard Medical School; Director of Transitional Residency Training Program, Cambridge Health Alliance
Contributor Information and Disclosures

Updated: Dec 17, 2008

Differential Diagnoses

Appendicitis, Acute
Shock, Septic
Pelvic Inflammatory Disease
Urinary Tract Infection, Female
Pregnancy, Ectopic
Vaginitis
Pregnancy, Trauma
Vulvovaginitis
Pregnancy, Urinary Tract Infections

Workup

Laboratory Studies

  • Complete blood count
  • Erythrocyte sedimentation rate
  • Beta-human chorionic gonadotropin; quantitative levels may provide a basis for future comparison
  • Electrolytes, glucose, BUN, and creatinine
  • Blood type and screen
  • Endocervical cultures (eg, aerobic, anaerobic, gonorrheal, chlamydial) and Gram stain
  • Blood cultures

Imaging Studies

  • Perform an ultrasound examination to identify retained products of conception in the uterus, adnexal masses, and free fluid in the cul-de-sac.
  • Both supine and upright radiographs of the abdomen assist in detection of free air or foreign bodies. Perform an exploratory laparotomy if a large amount of free air under the diaphragm is accompanied by fever, chills, vaginal bleeding, and abdominal pain.

More on Abortion, Septic

Overview: Abortion, Septic
Differential Diagnoses & Workup: Abortion, Septic
Treatment & Medication: Abortion, Septic
Follow-up: Abortion, Septic
References

References

  1. Cates W, Rochat RW, Grimes DA, Tyler CW Jr. Legalized abortion: effect on national trends of maternal and abortion-related mortality (1940 through 1976). Am J Obstet Gynecol. Sep 15 1978;132(2):211-4. [Medline].

  2. Chatterjee C, Joardar GK, Mukherjee G, Chakraborty M. Septic abortions: a descriptive study in a teaching hospital at North Bengal, Darjeeling. Indian J Public Health. Jul-Sep 2007;51(3):193-4:[Medline].

  3. CherpesTL, Kusne S, Hillier SL. Haemophilus influenzae septic abortion. Infec Dis Obstet Gynecol. 2002;10(3):161-4. [Medline].

  4. Finkielman JD, De Feo FD, Heller PG, Afessa B. The clinical course of patients with septic abortion admitted to an intensive care unit. Intensive Care Med. Jun 2004;30(6):1097-102. [Medline].

  5. Jewett JF. Septic induced abortion. N Engl J Med. Oct 4 1973;289(14):748-9. [Medline].

  6. Kollef MH, Schuster DP. The acute respiratory distress syndrome. N Engl J Med. Jan 5 1995;332(1):27-37. [Medline].

  7. Osazuwa H, Aziken M. Septic abortion: a review of social and demographic characteristics. Arch Gynecol Obstet. Feb 2007;275(2):117-9:[Medline].

  8. Rana A, Pradhan N, Gurung G, Singh M. Induced septic abortion: a major factor in maternal mortality and morbidity. J Obstet Gynaecol Res. Feb 2004;30(1):3-8. [Medline].

  9. Rochelson B, Scher L, Warshawsky R, Simon D. Use of a temporary vena cava filter in a woman with septic abortion and inferior vena cava thrombosis. A case report. J Reprod Med. Jul 2003;48(7):557-9. [Medline].

  10. Scott JR. Early pregnancy loss (septic abortion). In: Danforth's Obstetric and Gynecology. Lippincott-Raven Publishers; 1994:179.

  11. Soper DE. Abortion and clostridial toxic shock syndrome. Obstet Gynecol. Nov 2007;110(5):970-1:[Medline].

  12. Stevenson MM, Radcliffe KW. Preventing pelvic infection after abortion. Int J STD AIDS. Sep-Oct 1995;6(5):305-12. [Medline].

  13. Stubblefield PG, Grimes DA. Septic abortion. N Engl J Med. Aug 4 1994;331(5):310-4. [Medline].

Further Reading

Keywords

septic abortion, miscarriage, spontaneous abortion, therapeutic abortion, artificial abortion, pelvic infection, pelvic inflammatory disease, PID

Contributor Information and Disclosures

Author

Slava V Gaufberg, MD, Assistant Professor of Medicine, Harvard Medical School; Director of Transitional Residency Training Program, Cambridge Health Alliance
Slava V Gaufberg, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Roy Alson, MD, PhD, FACEP, FAAEM, Associate Professor, Department of Emergency Medicine, Wake Forest University School of Medicine; Medical Director, Forsyth County EMS; Deputy Medical Advisor, North Carolina Office of EMS; Associate Medical Director, North Carolina Baptist AirCare
Roy Alson, MD, PhD, FACEP, FAAEM is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, North Carolina Medical Society, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark Zwanger, MD, MBA, Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University
Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

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