Clinical Pearls

The bacteria involved in septic abortion usually are polymicrobial, particularly anaerobes that have ascended from the lower genital tract.

Hemorrhage often complicates the curettage for septic abortion.

Treatment of septic abortion consists of maintaining blood pressure; monitoring blood pressure, oxygenation, and urine output; antibiotics; and uterine evacuation.


Mishell DR. Spontaneous and recurrent abortion. In: Stenchever MA. Droegemueller W. Herbst AL, Mishell DR. eds. Comprehensive gynecology, 4th ed. St. Louis: Mosby-Year Book. 2001:413-442.

Lu MC, Hobel CJ. Antepartum care: preconception and prenatal care, genetic evaluation and teratology, and antenatal fetal assessment. In: Hacker NF. Moore JG, Gambone JC. eds. Essentials of obstetrics and gynecology, 4th ed. Philadelphia: Saunders, 2004:83-103.

Soper DE. Upper genital tract infections. In: Copeland LJ. Jarrell JF, eds. Textbook of gynecology, 2nd ed. Philadelphia: Saunders. 2000:795-797.

A 29-year-old G5 P4 woman at 39 weeks' gestation with preeclampsia delivers vaginally. Her prenatal course has been uncomplicated except for asymptomatic bacteriuria caused by Escherichia coli in the first trimester treated with oral cephalexin. She denies a family history of bleeding diathesis. After the placenta is delivered, there is appreciable vaginal bleeding estimated at 1000 mL.

♦ What is the most likely diagnosis?

♦ What is the next step in therapy?

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