Volume : IX, Issue : II, February - 2019

SEPTIC ABORTION: WHOM TO SAVE; MOTHER OR UTERUS?

Dr. Reena. Wani, Dr. Namrita. Sheregar, Dr. Sachin. Paprikar

Abstract :

Septic abortion is the result of an unsafe abortion defined as termination of pregnancy carried out by a person lacking necessary skills or in an environment lacking minimal medical standards or both. It is one of the important causes of maternal mortality. The incidence of septic abortions is 10%.We report here a case of septic abortion and the dilemmas in its management. A 12 year old unmarried girl presented to surgery OPD with acute abdominal pain, fever and vomiting. X Ray showed gas under diaphragm. Exploratory laparotomy was done by surgeons with suspicion of intestinal perforation. Intraoperatively, when uterus was found to be gangrenous, gynaecologists were called. Decision was taken to conserve the uterus considering the age of the patient and non– availability of parents and proper history. Postoperative enquiry revealed history of clandestine abortion at 3 months amenorrhoea in the village. Initial post–operative period was uneventful except for occasional fever spikes. However, on Day 14 when suture removal was done, there was wound dehiscence. The patient was taken up for re–exploration on account of fever spikes with suspicion of burst abdomen. Intraoperatively, defect was found in fundus of uterus. Bony spicules were found in uterine cavity. Hence, decision of total abdominal hysterectomy was taken. The patient recovered well and went home on day 45. Dilemmas in diagnosis and options of management will be discussed.

Keywords : abortion   perforation   burst abdomen   

Article:Download PDF Journal DOI : 10.15373/2249555X

Cite This Article:

SEPTIC ABORTION: WHOM TO SAVE; MOTHER OR UTERUS?, Dr. Reena. Wani, Dr. Namrita. Sheregar, Dr.Sachin.Paprikar INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-2 | February-2019


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