25:
173:
the unsafe abortions occurred in Asia, with most in south and central Asia, and Africa. Global data from a 2008 systematic analysis also estimated that complications from unsafe abortions accounted for 13% of all maternal deaths. Furthermore, in a retrospective case study, it was found that maternal mortality associated with septic abortion was approximately 19%; however a systematic review of global data is still needed.
177:
due to a higher utilization of illicit abortion procedures carried out by non-doctors due to the inherent barriers in obtaining abortion. Therefore, "societies with high fertility rate, low contraceptive usage, and legal obstacles to safe termination of pregnancy" predisposes the society to a higher prevalence of septic abortion.
322:
a fever, ill appearance, abdominal pain, vaginal bleeding, trauma to the cervix and other potentially worrisome symptoms of an infection. Differential diagnosis of a septic abortion includes incomplete abortion with a cause of fever or spontaneous abortion with signs of inflammation redness of the lining of the uterus.
321:
on people who present with signs and symptoms with intrauterine infections following by an abortion within 20 weeks of gestation. Medical history and physical examination are used as the first line in identifying people who are suspected of having a septic abortion. A woman may present initially with
145:
By definition, septic abortion is caused by a variety of bacterial infections. Bacteria can come from vaginal and endocervical flora or can be transmitted sexually. The development of sepsis is primarily due to two scenarios. When there is an incomplete abortion caused by the pathogens that result in
136:
in most cases is caused by a combination of factors both due to facility conditions and/or individual predispositions. The infection often starts in the placenta and fetus, with a potential complication of also affecting the uterus, that can result in sepsis spreading to surrounding organs, or pelvic
721:
study showed that motivational interviewing on contraceptive use can increase the effective use of it immediately after interview and up to four months post-intervention. Another factor for preventing unsafe abortion is having access to safe, legal, and comprehensive abortion services. According to
172:
From 2015-2017, approximately 73.3 million abortions occurred worldwide each year. Furthermore, data from 2010-2014 showed that around 45% of these abortions were unsafe abortions, where 98% of these unsafe abortions occurred in developing countries. In particular, it was estimated that over 50% of
176:
Septic abortion is of highest prevalence in vulnerable populations living in resource-poor environments, with prevalence reaching as high as 86% in these populations. Within such environments, the incidence of septic abortion is highest among teenagers, and in areas with restrictive abortion laws
726:(WHO), 22 million unsafe abortions occur each year globally. Studies have shown that women appear to have low knowledge on abortion regulations and laws in their countries. In other words, the lack of knowledge on legal status of abortion can cause women to seek abortion services that are unsafe.
163:
is the most common cause especially in induced abortions. In situations where intentional abortion is performed illegally or in impoverished countries, there is a higher risk of septic complications because it is likely that the procedure was performed by non-professionals in unhygienic settings,
158:
species, staphylococcal strains, and other gram-positive or gram-negative bacteria. In 2011, an analysis was done to determine if a pregnant woman should be screened for Group B Streptococcus which has been found to be a cause for many diseases including septic abortion. Within the large range of
367:
that are taken for further diagnostic and treatment implications. Anaerobic bacterial, high vaginal, and cervical cultures can be used to identify the septic types and species of the offending microorganism. Primary organisms isolated are the non-clostridial anaerobic, microaerophilic bacteria,
180:
Nevertheless, although the incidence of septic abortion is highest among teenagers between the ages of 16 and 24 years, which constitutes two-thirds of the population affected by septic abortion, septic complications are still common in older married people who are assigned female at birth. The
672:
blood should be given to the woman in addition to an injection of Rh immune globulin, unless the father is also known to be Rh negative. The removal of the infected tissue is often one of the most effective treatments for septic abortion. In cases so severe that
146:
products of conception remaining in the body. The second scenario occurs intentional septic procedures leads to the spread of the infection from the placenta or fetus to the uterus; this can subsequently cause pelvic septicaemia. Possible pathogens include
372:
is the most pathogenic and is usually introduced into the genital tract externally as they are not normally found in the normal vaginal flora. Groups B and D are less virulent but it is also not found as the part of vaginal flora.
330:
Clinical findings are based on any infections ranging in severity in any patient presenting with fevers over 38 °C or 100.4 °F with severe abdominal pain and peritonitis, and foul smelling vaginal discharge. A complete
730:
have shown that education on legal situation of abortion services and knowledge on accessible safe services would reduce the chance of women seeking for unsafe options that would lead to complications such as septic abortions.
164:
making way for more exposure to infectious bacteria. Put in perspective, infection caused 62% of illegal abortion and 51% of miscarriages, however infection only caused 21% of deaths from legally performed septic abortions.
1298:
Kassebaum, Nicholas J.; Bertozzi-Villa, Amelia; Coggeshall, Megan S.; Shackelford, Katya A.; Steiner, Caitlyn; Heuton, Kyle R.; Gonzalez-Medina, Diego; Barber, Ryan; Huynh, Chantal; Dicker, Daniel; Templin, Tara (2014).
2298:"Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis"
1240:
Ganatra, Bela; Gerdts, Caitlin; Rossier, Clémentine; Johnson, Brooke Ronald; Tunçalp, Özge; Assifi, Anisa; Sedgh, Gilda; Singh, Susheela; Bankole, Akinrinola; Popinchalk, Anna; Bearak, Jonathan (2017).
755:
is preferred. Therefore, investigating blood cultures would be an important step to guide antibiotic therapy. Following up to date guidelines and well-studied treatment regimens is recommended.
335:(CBC) with differential should be done in people with a fever to assess the presence of leukocytosis and brandemic which are the infection markers. Labs such as electrolyte levels, glucose,
743:
that could prevent more serious infections. Initial assessments of patient's history, and symptoms can be helpful in understanding the severity of the problem. Physical exams and
482:
Ultrasonography, also known as "ultrasound", is often used following a clinical diagnosis to confirmed the specific location and the origin of a septic abortion.
2296:
Silversides, Jonathan A.; Major, Emmet; Ferguson, Andrew J.; Mann, Emma E.; McAuley, Daniel F.; Marshall, John C.; Blackwood, Bronagh; Fan, Eddy (2016-10-12).
124:
describes any type of abortion (intentional termination or miscarriage), due to an upper genital tract bacterial infection including the inflammation of the
1301:"Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013"
1876:
2012:
Grimes DA, Cates W Jr, Selik RM. Fatal septic abortion in the United States, 1975-1977. Obstetrics and
Gynecology. 1981 Jun;57(6):739-744. PMID: 7015204.
1900:
Wilson, Amie; Nirantharakumar, Krishnarajah; Truchanowicz, Ewa G.; Surenthirakumaran, Rajendra; MacArthur, Christine; Coomarasamy, Arri (August 2015).
751:
should be used to determine the main reason behind the infection. It has been found that variety of bacteria can lead to infected abortions and no one
629:
intravenous antibiotics should be given until the fever is gone. There are different antibiotic regimens which are almost equal such as intravenous
1902:"Motivational interviews to improve contraceptive use in populations at high risk of unintended pregnancy: a systematic review and meta-analysis"
1439:
779:
should be hospitalized for a course of antibiotic and evacuation of the remaining pregnancy tissue. If there is no response from emptying of the
1053:
Taminato, Mônica; Fram, Dayana; Torloni, Maria Regina; Belasco, Angélica Gonçalves Silva; Saconato, Humberto; Barbosa, Dulce
Aparecida (2011).
1152:
Bearak, Jonathan; Popinchalk, Anna; Ganatra, Bela; Moller, Ann-Beth; Tunçalp, Özge; Beavin, Cynthia; Kwok, Lorraine; Alkema, Leontine (2020).
302:(DIC). Intestinal organs may also become infected, potentially causing scar tissue with chronic pain, intestinal blockage, and infertility.
1154:"Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019"
1859:
Eschenbach, David A. MD. Treating
Spontaneous and Induced Septic Abortions. Obstetrics & Gynecology 125(5):p 1042-1048, May 2015. |
184:
Especially considering the emergence of antibiotic resistant bacteria, septic abortions are of high concern for the medical community.
1712:
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can be prevented by reducing the chances of unwanted pregnancies through comprehensive sexual education and optimal use of effective
1958:
Grimes, David A.; Benson, Janie; Singh, Susheela; Romero, Mariana; Ganatra, Bela; Okonofua, Friday E.; Shah, Iqbal H. (2006-11-25).
1243:"Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model"
739:
Secondary prevention of septic abortions can be achieved by early detection and treatment of inflammation of the lining of the
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299:
89:
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883:
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Pelvic abscess (a build up of fluid in the fallopian tube, ovaries, or parametric tissue that is also infected with bacteria)
61:
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After successful treatment of a septic abortion, a woman may be tired for several weeks. In case of substantial bleeding,
2357:
768:
68:
1959:
2182:"Bench-to-bedside review: Sepsis, severe sepsis and septic shock – does the nature of the infecting organism matter?"
108:
625:
or hypouresis are both names from roots meaning "not enough urine"; these terms refer to the low output of urine).
42:
767:
or death risk from the infection. If the infection is not eradicated and managed, it can lead to septic shock and
75:
573:
527:
46:
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should be monitored and adequate ventilation has to start if the saturation level drops below optimal levels.
713:. Unwanted pregnancies can be avoided and reduced by improving social equality which would prevent women from
540:
Tissue from the fetus or placenta is left inside the uterus after a miscarriage or elective abortion procedure
57:
1202:
355:) and fibrinogen should be looked at for any abnormalities especially with people with excessive bleeding.
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352:
487:
220:
Beginning miscarriage symptoms (heavy bleeding and or cramping) that suddenly stops and does not resume
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626:
181:
epidemiology of septic abortion is therefore dictated by risk factors and barriers to safe abortion.
1498:
Rotheram, E. B., & Schick, S. F. (1969). Nonclostridial anaerobic bacteria in septic abortion.
661:
159:
potential pathogens, in third world countries tetanus is the most common cause, while in the U.S.
1203:"Liberalization of abortion and reduction of abortion related morbidity and mortality in Nigeria"
657:. However, new studies are needed to establish the most effective antibiotic in septic abortion.
364:
314:
240:
35:
1356:
Finkielman, Javier Daniel; De Feo, Fabián Darío; Heller, Paula
Graciela; Afessa, Bekele (2004).
1055:"Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis"
815:
Udoh, Atim; Effa, Emmanuel E; Oduwole, Olabisi; Okusanya, Babasola O; Okafo, Obiamaka (2016).
82:
963:
2092:
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Assifi, Anisa R.; Berger, Blair; Tunçalp, Özge; Khosla, Rajat; Ganatra, Bela (2016-03-24).
685:
344:
332:
363:
In individuals who are suspected to have a septic abortion, there are a few variations of
8:
1358:"The clinical course of patients with septic abortion admitted to an intensive care unit"
534:
336:
2096:
564:
These are some of the complications that may occur especially if treatment is delayed:
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or the use of tampons should be avoided until recommended by the healthcare provider.
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1941:
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132:. The genital tract during this period is particularly vulnerable to infection, and
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348:
224:
1901:
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have formed in the ovaries and tubes, it may be necessary to remove the uterus by
305:
If the septic abortion is not treated quickly and effectively, the woman may die.
148:
Neisseria gonorrhoeae, Chlamydia trachomatis, Escherichia coli, Mycoplasma hominis
2105:
1917:
1864:
929:
638:
520:
2156:
1558:
Sherpa, Dawa; Johnson, Brian D.; Ben-Youssef, Leila; Nagdev, Arun (2017-07-06).
1470:
1423:
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589:
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The risk of post-abortion sepsis is increased by mainly the following factors:
291:
2313:
2256:
1373:
1218:
1106:
1015:
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Undergoing septic abortion procedures in resource-poor areas (unsafe abortion)
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2321:
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2047:
1983:
1925:
1827:
1689:
1632:
1583:
1536:
1381:
1324:
1266:
1130:
1080:
1023:
937:
893:
840:
787:. finally, patients with severe sepsis may develop ARDS. In that case, blood
748:
718:
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1357:
1297:
999:
913:
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2225:
2132:
2065:
2023:
1991:
1933:
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1711:
Rello, Jordi; Kollef, Martin H.; D??az, E.; Rodra-Guez, Alejandro (2007).
1697:
1138:
873:
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Tertiary prevention of septic abortion are approaches that minimize organ
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1524:
776:
772:
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262:
255:
125:
1906:
European
Journal of Obstetrics & Gynecology and Reproductive Biology
1617:"The Back Alley Revisited: Sepsis after Attempted Self-Induced Abortion"
1410:
Tenney, B., Little, A. B., & Wamsteker, E. (1957). Septic abortion.
2081:"Women's Awareness and Knowledge of Abortion Laws: A Systematic Review"
1201:
Okonta, Patrick I.; Ebeigbe, Peter N.; Sunday-Adeoye, Ileogben (2010).
784:
764:
752:
634:
340:
318:
201:
347:), antibody screening, lactate levels and coagulation studies such as
2241:"The Outcome of Septic Abortion: A Tertiary Care Hospital Experience"
1000:"Septic abortion: a review of social and demographic characteristics"
646:
546:
Undergoing septic abortion under illegal conditions (unsafe abortion)
523:
surrounding the fetus have ruptured, sometimes without being detected
129:
2024:"Women, abortion and the new technical and policy guidance from WHO"
1615:
Saultes, Teresa A; Devita, Diane; Heiner, Jason D. (November 2009).
24:
2198:
714:
706:
622:
269:
214:
674:
483:
276:
1666:"Second-trimester spontaneous abortion, the IUD, and infection"
780:
740:
568:
490:(MRI) may be also used. Findings of a septic abortion include:
477:
133:
1557:
783:, the patient could be indicated for another procedure called
2239:
Sreelakshmi, U.; Thejaswini, J.; Bharathi, T. (August 2014).
2238:
1465:, Cham: Springer International Publishing, pp. 179–200,
1151:
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may be ultilized to clean the uterus of any residual tissue.
197:
2295:
1560:"Diagnosis of Septic Abortion with Point-of-care Ultrasound"
1355:
205:
1239:
1710:
1200:
1052:
552:
Incomplete septic abortion such as late uterine evacuation
192:
Signs and symptoms related to septic abortion are mainly:
2078:
1529:
Scandinavian
Journal of Infectious Diseases. Supplementum
2180:
Gao, Hongmei; Evans, Timothy W; Finney, Simon J (2008).
878:. J. G. Grudzinskas, T. Chard. London: Springer London.
581:
Bacteraemia (a build up of bacteria in the blood stream)
313:
Septic abortion is diagnosed using clinical evaluation,
1957:
1738:
Khaliq, Khalida; Nama, Noor; Lopez, Richard A. (2021),
814:
543:
Insertion of tools, chemicals, or soaps into the uterus
705:
Most complications and deaths associated with septic
653:
is more effective to decrease the time of fever than
1953:
1951:
1614:
1105:Stubblefield, Phillip G.; Grimes, David A. (1994).
914:"Treating spontaneous and induced septic abortions"
875:
Spontaneous
Abortion : Diagnosis and Treatment
325:
49:. Unsourced material may be challenged and removed.
1525:"Anaerobic infections of the female genital tract"
1104:
961:
2245:The Journal of Obstetrics and Gynecology of India
1564:Clinical Practice and Cases in Emergency Medicine
213:Severe abdominal pain and/or cramping /or strong
2349:
1948:
1801:
771:(ARDS). In severe cases, women with high fever,
377:Table 1: pathogenic organisms in Septic Abortion
246:As the condition becomes more serious, signs of
2022:Fathalla, Mahmoud; Cook, Rebecca (2012-09-01).
1778:, Treasure Island (FL): StatPearls Publishing,
1746:, Treasure Island (FL): StatPearls Publishing,
1737:
2179:
2146:Ashworth, Felicity (1992), "Septic Abortion",
1802:Santamarina, B. A.; Smith, S. A. (June 1970).
1457:Brady, Paula C.; Pocius, Katherine D. (2016),
681:, and possibly other infected organs as well.
2150:, London: Springer London, pp. 119–132,
1670:American Journal of Obstetrics and Gynecology
1440:"Septic Abortion - Gynecology and Obstetrics"
1207:Acta Obstetricia et Gynecologica Scandinavica
997:
962:Stubblefield, Phillip; Grimes, David (2004).
621:to maintain blood pressure and urine output (
494:An enlarged uterus with or without hemorrhage
351:(PT), activated partial thromboplastin time (
2021:
1769:
1463:Handbook of Consult and Inpatient Gynecology
964:"Septic Abortion: Prevention and Management"
537:(IUD) was left in place during the pregnancy
478:Ultrasonography and other Imaging Techniques
1960:"Unsafe abortion: the preventable pandemic"
1456:
821:The Cochrane Database of Systematic Reviews
1770:Smith, David A.; Nehring, Sara M. (2021),
1522:
911:
817:"Antibiotics for treating septic abortion"
2272:
2215:
2197:
2155:
2122:
2104:
2055:
2028:Bulletin of the World Health Organization
1717:. Springer Science & Business Media.
1640:
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1332:
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1070:
848:
109:Learn how and when to remove this message
2145:
1663:
998:Osazuwa, Henry; Aziken, Michael (2007).
871:
734:
585:Disseminated intravascular coagulopathy
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1059:Revista Latino-Americana de Enfermagem
758:
300:disseminated intravascular coagulation
1855:
1853:
1621:Western Journal of Emergency Medicine
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1004:Archives of Gynecology and Obstetrics
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1714:Infectious Diseases in Critical Care
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47:adding citations to reliable sources
18:
16:Miscarriage due to uterine infection
1877:"Misoprostol for Postabortion Care"
970:. Lippincott Williams & Wilkins
769:acute respiratory distress syndrome
649:. And only one research found that
368:anaerobic streptococci. Group A of
152:Clostridium perfringens, Klebsiella
13:
1850:
1808:Clinical Obstetrics and Gynecology
1804:"Septic abortion and septic shock"
1444:Merck Manuals Professional Edition
1428:
982:
14:
2369:
1095:
952:
900:
801:
1820:10.1097/00003081-197006000-00006
1500:The American Journal of Medicine
968:Gynecology and Obstetrics CD-ROM
559:
326:Clinical evaluation and lab test
243:may mimic many of the symptoms.
23:
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2015:
2006:
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1412:New England Journal of Medicine
1404:
1349:
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1111:New England Journal of Medicine
1072:10.1590/s0104-11692011000600026
510:
358:
235:Backache or heavy back pressure
167:
34:needs additional citations for
1194:
1145:
1046:
865:
833:10.1002/14651858.CD011528.pub2
574:Septic pelvic thrombophlebitis
528:sexually transmitted infection
1:
1976:10.1016/S0140-6736(06)69481-6
1317:10.1016/S0140-6736(14)60696-6
1259:10.1016/S0140-6736(17)31794-4
1171:10.1016/S2214-109X(20)30315-6
912:Eschenbach, David A. (2015).
794:
717:sexual relationships. A 2015
695:
2106:10.1371/journal.pone.0152224
1918:10.1016/j.ejogrb.2015.05.010
1865:10.1097/AOG.0000000000000795
1682:10.1016/0002-9378(76)90099-5
1512:10.1016/0002-9343(69)90060-6
930:10.1097/AOG.0000000000000795
612:
439:Beta haemolytic streptococci
370:Beta haemolytic streptococci
308:
128:during or after 20 weeks of
7:
2157:10.1007/978-1-4471-1918-0_8
1471:10.1007/978-3-319-27724-0_8
1424:10.1056/nejm195711212572104
1123:10.1056/NEJM199408043310507
399:Bacteroides melaninogenicus
268:Little or no urine output (
10:
2374:
2358:Health issues in pregnancy
1576:10.5811/cpcem.2017.3.33574
488:magnetic resonance imaging
404:Peptostreptococcus species
200:, usually above 101 °
2314:10.1007/s00134-016-4573-3
2257:10.1007/s13224-014-0509-4
1664:Eisinger, Steven (1976).
1438:Dulay, Antonette (2020).
1374:10.1007/s00134-004-2207-7
1219:10.3109/00016341003801649
1016:10.1007/s00404-006-0233-0
918:Obstetrics and Gynecology
724:World Health Organization
140:
1158:The Lancet Global Health
872:Stabile, Isabel (1992).
662:dilatation and curettage
500:Free or unexpected fluid
2302:Intensive Care Medicine
1523:Thadepalli, H. (1979).
1459:"Spontaneous Abortions"
1362:Intensive Care Medicine
603:Clostridium perfringens
419:Clostridium perfringens
343:, liver function test (
250:may appear, including:
241:urinary tract infection
161:Clostridium perfringens
617:The woman should have
597:(most often caused by
497:Intrauterine materials
454:Pseudomonas aeruginosa
275:Respiratory distress (
261:Low body temperature (
2040:10.2471/blt.12.107144
469:Streptococcus milleri
464:Staphylococcus aureus
459:Neisseria gonorrhoeae
414:Fusobacterium species
2148:Spontaneous Abortion
1253:(10110): 2372–2381.
735:Secondary prevention
686:iron supplementation
503:Formation of abscess
449:Klebsiella aerogenes
434:Enterobacter species
395:Bacteroides fragilis
254:Low blood pressure (
43:improve this article
2097:2016PLoSO..1152224A
1970:(9550): 1908–1919.
759:Tertiary prevention
599:Clostridium welchii
535:intrauterine device
484:Computed tomography
409:Peptococcus species
382:
337:blood urea nitrogen
223:Prolonged or heavy
1311:(9947): 980–1004.
1164:(9): e1152–e1161.
773:pelvis peritonitis
728:Systematic reviews
701:Primary prevention
690:Sexual intercourse
619:intravenous fluids
424:Clostridium tetani
381:
315:bacterial cultures
296:bleeding diathesis
188:Signs and symptoms
2167:978-1-4471-1920-3
1724:978-3-540-34405-6
1480:978-3-319-27722-6
1418:(21), 1022–1025.
1107:"Septic Abortion"
885:978-1-4471-1918-0
789:oxygen saturation
555:Delayed treatment
530:such as chlamydia
475:
474:
281:labored breathing
231:vaginal discharge
119:
118:
111:
93:
58:"Septic abortion"
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1955:
1946:
1945:
1897:
1891:
1890:
1888:
1887:
1873:
1867:
1857:
1848:
1847:
1799:
1793:
1792:
1791:
1790:
1767:
1761:
1760:
1759:
1758:
1740:"Pelvic Abscess"
1735:
1729:
1728:
1708:
1702:
1701:
1661:
1655:
1654:
1644:
1612:
1606:
1605:
1595:
1555:
1549:
1548:
1520:
1514:
1496:
1490:
1489:
1488:
1487:
1454:
1448:
1447:
1435:
1426:
1408:
1402:
1401:
1368:(6): 1097–1102.
1353:
1347:
1346:
1336:
1295:
1289:
1288:
1278:
1237:
1231:
1230:
1213:(8): 1087–1090.
1198:
1192:
1191:
1173:
1149:
1143:
1142:
1102:
1093:
1092:
1074:
1065:(6): 1470–1478.
1050:
1044:
1043:
995:
980:
979:
977:
975:
959:
950:
949:
924:(5): 1042–1048.
909:
898:
897:
869:
863:
862:
852:
812:
688:may be helpful.
526:The woman has a
506:Intrauterine air
430:Escherichia coli
383:
380:
349:prothrombin time
225:vaginal bleeding
114:
107:
103:
100:
94:
92:
51:
27:
19:
2373:
2372:
2368:
2367:
2366:
2364:
2363:
2362:
2348:
2347:
2346:
2345:
2294:
2290:
2237:
2233:
2178:
2174:
2168:
2144:
2140:
2091:(3): e0152224.
2077:
2073:
2020:
2016:
2011:
2007:
1956:
1949:
1898:
1894:
1885:
1883:
1875:
1874:
1870:
1858:
1851:
1800:
1796:
1788:
1786:
1768:
1764:
1756:
1754:
1736:
1732:
1725:
1709:
1705:
1662:
1658:
1613:
1609:
1556:
1552:
1521:
1517:
1497:
1493:
1485:
1483:
1481:
1455:
1451:
1436:
1429:
1409:
1405:
1354:
1350:
1296:
1292:
1238:
1234:
1199:
1195:
1150:
1146:
1103:
1096:
1051:
1047:
996:
983:
973:
971:
960:
953:
910:
901:
886:
870:
866:
827:(7): CD011528.
813:
802:
797:
761:
737:
703:
698:
639:chloramphenicol
615:
562:
521:fetal membranes
513:
480:
444:Proteus species
361:
328:
319:ultrasonography
311:
190:
170:
143:
122:Septic abortion
115:
104:
98:
95:
52:
50:
40:
28:
17:
12:
11:
5:
2371:
2361:
2360:
2344:
2343:
2308:(2): 155–170.
2288:
2251:(4): 265–269.
2231:
2199:10.1186/cc6862
2172:
2166:
2138:
2071:
2014:
2005:
1947:
1892:
1868:
1849:
1814:(2): 291–304.
1794:
1762:
1730:
1723:
1703:
1676:(4): 393–397.
1656:
1627:(4): 278–280.
1607:
1570:(3): 268–269.
1550:
1515:
1491:
1479:
1449:
1427:
1403:
1348:
1290:
1232:
1193:
1144:
1117:(5): 310–314.
1094:
1045:
1010:(2): 117–119.
981:
951:
899:
884:
864:
799:
798:
796:
793:
760:
757:
749:blood cultures
736:
733:
711:contraceptions
702:
699:
697:
694:
627:Broad-spectrum
614:
611:
610:
609:
606:
592:
587:
582:
579:
576:
571:
561:
558:
557:
556:
553:
550:
547:
544:
541:
538:
531:
524:
512:
509:
508:
507:
504:
501:
498:
495:
479:
476:
473:
472:
427:
391:
390:
387:
360:
357:
327:
324:
310:
307:
292:kidney failure
285:
284:
273:
266:
259:
237:
236:
233:
229:Foul-smelling
227:
221:
218:
211:
208:
189:
186:
169:
166:
142:
139:
117:
116:
31:
29:
22:
15:
9:
6:
4:
3:
2:
2370:
2359:
2356:
2355:
2353:
2339:
2335:
2331:
2327:
2323:
2319:
2315:
2311:
2307:
2303:
2299:
2292:
2284:
2280:
2275:
2270:
2266:
2262:
2258:
2254:
2250:
2246:
2242:
2235:
2227:
2223:
2218:
2213:
2209:
2205:
2200:
2195:
2191:
2187:
2186:Critical Care
2183:
2176:
2169:
2163:
2158:
2153:
2149:
2142:
2134:
2130:
2125:
2120:
2116:
2112:
2107:
2102:
2098:
2094:
2090:
2086:
2082:
2075:
2067:
2063:
2058:
2053:
2049:
2045:
2041:
2037:
2033:
2029:
2025:
2018:
2009:
2001:
1997:
1993:
1989:
1985:
1981:
1977:
1973:
1969:
1965:
1961:
1954:
1952:
1943:
1939:
1935:
1931:
1927:
1923:
1919:
1915:
1911:
1907:
1903:
1896:
1882:
1878:
1872:
1866:
1862:
1856:
1854:
1845:
1841:
1837:
1833:
1829:
1825:
1821:
1817:
1813:
1809:
1805:
1798:
1785:
1781:
1777:
1773:
1766:
1753:
1749:
1745:
1741:
1734:
1726:
1720:
1716:
1715:
1707:
1699:
1695:
1691:
1687:
1683:
1679:
1675:
1671:
1667:
1660:
1652:
1648:
1643:
1638:
1634:
1630:
1626:
1622:
1618:
1611:
1603:
1599:
1594:
1589:
1585:
1581:
1577:
1573:
1569:
1565:
1561:
1554:
1546:
1542:
1538:
1534:
1531:(19): 80–91.
1530:
1526:
1519:
1513:
1509:
1505:
1501:
1495:
1482:
1476:
1472:
1468:
1464:
1460:
1453:
1445:
1441:
1434:
1432:
1425:
1421:
1417:
1413:
1407:
1399:
1395:
1391:
1387:
1383:
1379:
1375:
1371:
1367:
1363:
1359:
1352:
1344:
1340:
1335:
1330:
1326:
1322:
1318:
1314:
1310:
1306:
1302:
1294:
1286:
1282:
1277:
1272:
1268:
1264:
1260:
1256:
1252:
1248:
1244:
1236:
1228:
1224:
1220:
1216:
1212:
1208:
1204:
1197:
1189:
1185:
1181:
1177:
1172:
1167:
1163:
1159:
1155:
1148:
1140:
1136:
1132:
1128:
1124:
1120:
1116:
1112:
1108:
1101:
1099:
1090:
1086:
1082:
1078:
1073:
1068:
1064:
1060:
1056:
1049:
1041:
1037:
1033:
1029:
1025:
1021:
1017:
1013:
1009:
1005:
1001:
994:
992:
990:
988:
986:
969:
965:
958:
956:
947:
943:
939:
935:
931:
927:
923:
919:
915:
908:
906:
904:
895:
891:
887:
881:
877:
876:
868:
860:
856:
851:
846:
842:
838:
834:
830:
826:
822:
818:
811:
809:
807:
805:
800:
792:
790:
786:
782:
778:
774:
770:
766:
756:
754:
750:
746:
742:
732:
729:
725:
720:
719:meta-analysis
716:
712:
708:
693:
691:
687:
682:
680:
676:
671:
667:
664:(D&C) or
663:
658:
656:
652:
648:
644:
640:
636:
632:
628:
624:
620:
607:
604:
600:
596:
593:
591:
590:Renal failure
588:
586:
583:
580:
577:
575:
572:
570:
567:
566:
565:
560:Complications
554:
551:
548:
545:
542:
539:
536:
532:
529:
525:
522:
518:
517:
516:
505:
502:
499:
496:
493:
492:
491:
489:
485:
471:
470:
466:
465:
461:
460:
456:
455:
451:
450:
446:
445:
441:
440:
436:
435:
431:
428:
426:
425:
421:
420:
416:
415:
411:
410:
406:
405:
401:
400:
396:
393:
392:
388:
385:
384:
379:
378:
374:
371:
366:
356:
354:
350:
346:
342:
338:
334:
323:
320:
316:
306:
303:
301:
297:
293:
289:
282:
278:
274:
271:
267:
264:
260:
257:
253:
252:
251:
249:
244:
242:
234:
232:
228:
226:
222:
219:
216:
212:
209:
207:
203:
199:
195:
194:
193:
185:
182:
178:
174:
165:
162:
157:
153:
149:
138:
135:
131:
127:
123:
113:
110:
102:
91:
88:
84:
81:
77:
74:
70:
67:
63:
60: –
59:
55:
54:Find sources:
48:
44:
38:
37:
32:This article
30:
26:
21:
20:
2305:
2301:
2291:
2248:
2244:
2234:
2189:
2185:
2175:
2147:
2141:
2088:
2084:
2074:
2031:
2027:
2017:
2008:
1967:
1963:
1909:
1905:
1895:
1884:. Retrieved
1881:www.acog.org
1880:
1871:
1811:
1807:
1797:
1787:, retrieved
1775:
1772:"Bacteremia"
1765:
1755:, retrieved
1743:
1733:
1713:
1706:
1673:
1669:
1659:
1624:
1620:
1610:
1567:
1563:
1553:
1528:
1518:
1506:(1), 80–89.
1503:
1499:
1494:
1484:, retrieved
1462:
1452:
1443:
1415:
1411:
1406:
1365:
1361:
1351:
1308:
1304:
1293:
1250:
1246:
1235:
1210:
1206:
1196:
1161:
1157:
1147:
1114:
1110:
1062:
1058:
1048:
1007:
1003:
972:. Retrieved
967:
921:
917:
874:
867:
824:
820:
762:
745:pelvic exams
738:
704:
683:
679:hysterectomy
659:
655:penicillin G
651:tetracycline
616:
602:
598:
595:Septic shock
563:
514:
511:Risk factors
481:
468:
467:
463:
462:
458:
457:
453:
452:
448:
447:
443:
442:
438:
437:
433:
432:
429:
423:
422:
418:
417:
413:
412:
408:
407:
403:
402:
398:
397:
394:
376:
375:
369:
362:
359:Microbiology
329:
312:
304:
290:may lead to
288:Septic shock
286:
248:septic shock
245:
238:
191:
183:
179:
175:
171:
168:Epidemiology
160:
155:
151:
147:
144:
137:infections.
121:
120:
105:
99:January 2017
96:
86:
79:
72:
65:
53:
41:Please help
36:verification
33:
777:tachycardia
747:as well as
670:Rh negative
666:misoprostol
643:cephalothin
631:clindamycin
333:blood count
263:hypothermia
256:hypotension
126:endometrium
2192:(3): 212.
2034:(9): 712.
1964:The Lancet
1886:2021-07-27
1789:2021-07-30
1776:StatPearls
1757:2021-07-30
1744:StatPearls
1486:2021-07-27
795:References
785:laparotomy
765:disability
753:antibiotic
696:Prevention
635:penicillin
386:Anaerobic
341:creatinine
239:A cold or
204:/ 38
69:newspapers
2322:0342-4642
2265:0971-9202
2208:1364-8535
2115:1932-6203
2048:0042-9686
1984:0140-6736
1926:0301-2115
1912:: 72–79.
1828:0009-9201
1690:0002-9378
1633:1936-900X
1584:2474-252X
1537:0300-8878
1382:0342-4642
1325:1474-547X
1267:1474-547X
1188:220773189
1131:0028-4793
1081:1518-8345
1024:1432-0711
938:1873-233X
894:853269541
841:1469-493X
707:abortions
675:abscesses
647:kanamycin
613:Treatment
309:Diagnosis
130:gestation
2352:Category
2330:27734109
2283:25136172
2226:18466647
2133:27010629
2085:PLOS ONE
2066:22984317
1992:17126724
1942:21204804
1934:26093351
1844:24001383
1784:28723008
1752:31424876
1651:20046250
1602:29849309
1390:15007546
1343:24797575
1285:28964589
1227:20636247
1180:32710833
1089:22249684
1040:28129686
1032:16947056
974:July 27,
946:25932831
859:27364644
715:coercive
623:oliguria
486:(CT) or
389:Aerobic
365:cultures
270:oliguria
217:pressure
215:perineal
2338:9366377
2274:4126947
2217:2481435
2124:4807003
2093:Bibcode
2057:3442397
2000:6188636
1836:4923486
1698:1251860
1642:2791734
1593:5965189
1398:1085171
1334:4255481
1276:5711001
1139:8022443
850:6458041
339:(BUN),
277:dyspnea
156:Proteus
83:scholar
2336:
2328:
2320:
2281:
2271:
2263:
2224:
2214:
2206:
2164:
2131:
2121:
2113:
2064:
2054:
2046:
1998:
1990:
1982:
1940:
1932:
1924:
1842:
1834:
1826:
1782:
1750:
1721:
1696:
1688:
1649:
1639:
1631:
1600:
1590:
1582:
1545:379990
1543:
1535:
1477:
1396:
1388:
1380:
1341:
1331:
1323:
1305:Lancet
1283:
1273:
1265:
1247:Lancet
1225:
1186:
1178:
1137:
1129:
1087:
1079:
1038:
1030:
1022:
944:
936:
892:
882:
857:
847:
839:
781:uterus
775:, and
741:uterus
569:Sepsis
317:, and
298:, and
210:Chills
141:Causes
134:sepsis
85:
78:
71:
64:
56:
2334:S2CID
1996:S2CID
1938:S2CID
1840:S2CID
1394:S2CID
1184:S2CID
1036:S2CID
645:plus
637:plus
608:Death
198:fever
196:High
90:JSTOR
76:books
2326:PMID
2318:ISSN
2279:PMID
2261:ISSN
2222:PMID
2204:ISSN
2162:ISBN
2129:PMID
2111:ISSN
2062:PMID
2044:ISSN
1988:PMID
1980:ISSN
1930:PMID
1922:ISSN
1832:PMID
1824:ISSN
1780:PMID
1748:PMID
1719:ISBN
1694:PMID
1686:ISSN
1647:PMID
1629:ISSN
1598:PMID
1580:ISSN
1541:PMID
1533:ISSN
1475:ISBN
1386:PMID
1378:ISSN
1339:PMID
1321:ISSN
1281:PMID
1263:ISSN
1223:PMID
1176:PMID
1135:PMID
1127:ISSN
1085:PMID
1077:ISSN
1028:PMID
1020:ISSN
976:2021
942:PMID
934:ISSN
890:OCLC
880:ISBN
855:PMID
837:ISSN
825:2016
722:the
601:and
519:The
353:aPTT
279:and
154:and
62:news
2310:doi
2269:PMC
2253:doi
2212:PMC
2194:doi
2152:doi
2119:PMC
2101:doi
2052:PMC
2036:doi
1972:doi
1968:368
1914:doi
1910:191
1861:doi
1816:doi
1678:doi
1674:124
1637:PMC
1588:PMC
1572:doi
1508:doi
1467:doi
1420:doi
1416:257
1370:doi
1329:PMC
1313:doi
1309:384
1271:PMC
1255:doi
1251:390
1215:doi
1166:doi
1119:doi
1115:331
1067:doi
1012:doi
1008:275
926:doi
922:125
845:PMC
829:doi
533:An
345:LFT
45:by
2354::
2332:.
2324:.
2316:.
2306:43
2304:.
2300:.
2277:.
2267:.
2259:.
2249:64
2247:.
2243:.
2220:.
2210:.
2202:.
2190:12
2188:.
2184:.
2160:,
2127:.
2117:.
2109:.
2099:.
2089:11
2087:.
2083:.
2060:.
2050:.
2042:.
2032:90
2030:.
2026:.
1994:.
1986:.
1978:.
1966:.
1962:.
1950:^
1936:.
1928:.
1920:.
1908:.
1904:.
1879:.
1852:^
1838:.
1830:.
1822:.
1812:13
1810:.
1806:.
1774:,
1742:,
1692:.
1684:.
1672:.
1668:.
1645:.
1635:.
1625:10
1623:.
1619:.
1596:.
1586:.
1578:.
1566:.
1562:.
1539:.
1527:.
1504:46
1502:,
1473:,
1461:,
1442:.
1430:^
1414:,
1392:.
1384:.
1376:.
1366:30
1364:.
1360:.
1337:.
1327:.
1319:.
1307:.
1303:.
1279:.
1269:.
1261:.
1249:.
1245:.
1221:.
1211:89
1209:.
1205:.
1182:.
1174:.
1160:.
1156:.
1133:.
1125:.
1113:.
1109:.
1097:^
1083:.
1075:.
1063:19
1061:.
1057:.
1034:.
1026:.
1018:.
1006:.
1002:.
984:^
966:.
954:^
940:.
932:.
920:.
916:.
902:^
888:.
853:.
843:.
835:.
823:.
819:.
803:^
660:A
641:,
633:,
294:,
206:°C
150:,
2340:.
2312::
2285:.
2255::
2228:.
2196::
2154::
2135:.
2103::
2095::
2068:.
2038::
2002:.
1974::
1944:.
1916::
1889:.
1863::
1846:.
1818::
1727:.
1700:.
1680::
1653:.
1604:.
1574::
1568:1
1547:.
1510::
1469::
1446:.
1422::
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