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Pelvic abscess. A sequela of first trimester abortion
Obstetrics and Gynecology
|December 1, 1976
Summary
First trimester abortions had a 0.52% infectious morbidity rate. Pelvic abscesses, linked to uterine perforation, require prompt antibiotic and surgical management, including colpotomy or laparotomy for severe cases.
Area of Science:
- Gynecology
- Surgical Procedures
- Infectious Disease
Background:
- This study analyzes infectious morbidity following first-trimester therapeutic abortions.
- It examines complications requiring hospital readmission over an 18-month period.
Observation:
- A total of 6790 therapeutic abortions were performed between January 1, 1972, and December 31, 1973.
- The infectious morbidity rate requiring hospital readmission was 0.52 per 100 women.
Findings:
- Four cases of pelvic abscess were diagnosed, presumed to be related to uterine perforation.
- Inadequate management of uterine perforation was identified as a probable cause.
Implications:
- Initial management involves systemic antibiotics and surgical drainage (colpotomy) for uterine perforation.
- Specific antibiotics for Bacteroides fragilis and assessment for bowel injury are crucial.
- Laparotomy is indicated for unresponsive cases to address potential bowel injury and ensure adequate drainage.