WordNet

of or relating to or caused by putrefaction; "the septic action occurs at the bottom of the septic tank"
containing or resulting from disease-causing organisms; "a septic sore throat"; "a septic environment"; "septic sewage" (同)infected
termination of pregnancy

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腐敗性の / 敗血症[性]の
〈U〉〈C〉流産;妊娠中絶 / 〈U〉(計画などの)失敗;〈C〉(実現しなかった)案,計画

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/15 14:13:48」(JST)

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A septic abortion or septic miscarriage is a form of miscarriage that is associated with a serious uterine infection. The infection carries risk of spreading infection to other parts of the body and cause sepsis, a grave risk to the life of the woman.

Signs and symptoms

In a woman with septic abortion, signs and symptoms that are related to the infection are mainly:

High fever, usually above 101 °F
Chills
Severe abdominal pain and/or cramping /or strong perineal pressure
Beginning miscarriage symptoms (heavy bleeding and or cramping) that suddenly stops and does not resume
Prolonged or heavy vaginal bleeding
Foul-smelling vaginal discharge
Backache or heavy back pressure

A cold or urinary tract infection may mimic many of the symptoms.

As the condition becomes more serious, signs of septic shock may appear, including:

Low blood pressure (hypotension)
Low body temperature (hypothermia)
Little or no urine output (oliguria)
Respiratory distress (dyspnea and labored breathing)

Septic shock may lead to kidney failure, bleeding diathesis, and disseminated intravascular coagulation (DIC). Intestinal organs may also become infected, potentially causing scar tissue with chronic pain, intestinal blockage, and infertility.

If the septic abortion is not treated quickly and effectively, the woman may die.

Causes

A septic abortion can occur when bacteria enters the uterus. The bacteria may also belong to the vaginal flora. Also, sexually transmitted infections (STI) such as chlamydia may cause septic abortion.

Risk factors

The risk of a septic abortion is increased by mainly the following factors:

The fetal membranes surrounding the unborn child have ruptured, sometimes without being detected
The woman has a sexually transmitted infection such as chlamydia
An intrauterine device (IUD) was left in place during the pregnancy
Tissue from the unborn child or placenta is left inside the uterus after a miscarriage or elective abortion procedure
Unsafe abortion was made to end the pregnancy
Insertion of tools, chemicals, or soaps into the uterus

Prevention

Better birth control and legal abortion (to prevent unsafe abortions) have dramatically reduced the number of septic abortions. To decrease the risk further, a woman should be tested for common sexually transmitted infections in the first trimester of her pregnancy. If a woman thinks she might be miscarrying or has miscarried, she should call her healthcare provider immediately.

Treatment

The woman should have intravenous fluids to maintain blood pressure and urine output (Oliguria or hypouresis both names from roots meaning "not enough urine" is the low output of urine). Broad-spectrum intravenous antibiotics should be given until the fever is gone.

A dilatation and curettage (D&C) or misoprostol may be needed to clean the uterus of any residual tissue. Rh negative blood should be given to the patient in addition to an injection of Rh immune globulin, unless the father is also known to be Rh negative. In cases so severe that abscesses have formed in the ovaries and tubes, it may be necessary to remove the uterus by hysterectomy, and possibly other infected organs as well.

After successful treatment of a septic abortion, a woman may be tired for several weeks. In case of substantial bleeding, iron supplementation may be helpful. Sexual intercourse or the use of tampons should be avoided until recommended by the healthcare provider.

References

UpToDate Contents

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1. 自然流産：管理 spontaneous abortion management
2. 自然流産：危険因子、病因、臨床症状、および診断的評価 spontaneous abortion risk factors etiology clinical manifestations and diagnostic evaluation
3. 危険を伴う中絶 unsafe abortion
4. 妊娠中の播種性血管内凝固 disseminated intravascular coagulation during pregnancy
5. 思春期女性における急性骨盤痛の評価 evaluation of acute pelvic pain in the adolescent female

English Journal

Uterocutaneous fistula following septic abortion: Can it heal without major surgical intervention?

Pratibha S1, Rajni B.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.J Obstet Gynaecol.2015 Aug 24:1-2. [Epub ahead of print]
PMID 25526507

Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India.

Prakash J1, Pant P, Singh AK, Sriniwas S, Singh VP, Singh U.
Renal failure.Ren Fail.2015 Jul 2:1-5. [Epub ahead of print]
RATIONAL: Obstetrical complications are the commonest causes of Renal Cortical Necrosis (RCN). However, the overall incidence of RCN in obstetric acute kidney injury in developing countries has been decreasing in recent years.OBJECTIVE: The aim of this study was to evaluate the changing profile of R
PMID 26133740

Denial of abortion in legal settings.

Gerdts C1, DePiñeres T2, Hajri S3, Harries J4, Hossain A5, Puri M6, Vohra D7, Foster DG8.
The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists.J Fam Plann Reprod Health Care.2015 Jul;41(3):161-3. doi: 10.1136/jfprhc-2014-100999. Epub 2014 Dec 15.
BACKGROUND: Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however,
PMID 25511805

Japanese Journal

Anuric Acute Renal Failure after Elective Abortion

Lim Lee-Moay,Tsai Kun-Bow,Hwang Daw-Yang,Kuo Mei-Chuan,Chiu Yi-Wen,Chen Hung-Chun
Internal Medicine 50(16), 1715-1718, 2011
… Elective abortion complicated by bilateral renal cortical necrosis (BRCN) is not common in a developed country. … We reported a patient having anuric acute renal failure after elective abortion. … The patient was treated as septic abortion and reached partial renal recovery after antibiotic treatment and short-term hemodialysis. …
NAID 130000969374

Induced septic abortion : A major factor in maternal mortality and morbidity

RANA Ashma,PRADHAN Neelam,GURUNG Geeta,SINGH Meeta
The Journal of obstetrics and gynaecology research 30(1), 3-8, 2004-02-01
NAID 10013778357

インフルエンザ菌Haemophilus influenzaeによる感染性流早産の3例

石川薫,伊藤友美,鈴木佳奈子,斉藤順子,生駒容子,大沼美香,羽柴良樹,久野尚彦,三輪貴彦,堀部暢人,水野公雄,石塚隆夫,風戸貞之
日本産科婦人科學會雜誌 52(4), 689-693, 2000-04-01
… Both patients with abortion had a severe course , one of them with septic pre-shock demanding intensive care treatment .The patient with preterm labor syndrome developed a tocolysis resistant course. …
NAID 110002231181