Radical surgery in septic abortion
Chatterjee, P.; Ghosh, M.; Ghosh, S.
Journal of Obstetrics and Gynaecology of India 29(4): 770-777
1979
ISSN/ISBN: 0971-9202 PMID: 12336028 Document Number: 575248
Ten cases of septic abortion were analyzed and in all of them hysterectomy was performed. Hysterectomy was undertaken as an emergency measure (in 4 cases) and in some cases (6 cases) after a period of conservative treatment. The timing of laparotomy varied between 12 and 144 h. With laparotomy, in 9 cases a uterine rent was detected; in 1 of the 9 patients, the posterior wall of the cervix was perforated by a stick. Mechanical obstruction due to internal adhesions to the uterine rent was detected in 5 cases. Emergency laparotomy and hysterectomy were performed in 3 cases. In 2 the uterine fundus was traumatized durig dilatation and evacuation operation after control of sepsis. In another case the patient was admitted in a collapsed state with perforated cervical wall by means of a stick, inserted 12 h before admission to the hospital. Six patients survived and 4 died. In all these 4 cases, the patients came to the hospital late, 2 came 6 days after interference and the other 2 were admitted 1 wk after. The place for radical surgery, i.e., hysterectomy, is discussed. This treatment is justified in some cases of septic abortion, although correct timing of this operation is vitally important in these poor-risk patients.