Pelvic abscess. A sequela of first trimester abortion

First trimester therapeutic abortions were performed in 6790 patients from January 1, 1972, through December 31, 1973. The infectious morbidity during an 18-month concurrent time period which required readmission to the hospital was 0.52 per 100 women. Four of these women were ultimately diagnosed as having a pelvic abscess thought to be related to the procedure. The cause was probably related to undiagnosed or inadequately managed uterine perforation. Initial management should consist of systemic antibiotics and, if possible, surgical drainage via colpotomy. Two special precautions which should be taken are the use of antibiotics specific for Bacteroides fragilis and the investigation of the possibility of bowel injury. Laparotomy should be considered in unresponsive cases because of the possibility of bowel injury and the necessity of adequate surgical drainage even with appropriate antibiotic coverage.