Is a miscarriage that take place as result of infection do to the present of microorganism in the body of the patients, Often septic miscarriage are cause by sexually transmitted infection. i.e Gonorrhoea etc.
Counselling the patient.
And then urgent evacuation of uterus and surgical management of the complications should be carried on the patient.
- Oxytocin, IV (intramuscular).
- Dilute 20 units in 1 L sodium chloride 0.9%, i.e. 20milliunits/mL solution administered at a rate of 125 mL/hour.
- Reduce rate if strong contractions are experienced.
- Ampicillin, IV, 1 g immediately, followed by 1 g 6 hourly.
- Gentamicin, IV, 6 mg/kg daily. PLUS
- Metronidazole, IV, 500 mg or oral, 400 mg 8 hourly.
Change to oral treatment after clinical improvement:
- Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly for 7–10 days.
Note: The addition of metronidazole to amoxicillin/clavulanic acid is unnecessary as amoxicillin/clavulanic acid has adequate anaerobic cover.
- Clindamycin, IV, 600 mg 8 hourly. PLUS
- Gentamicin, IV, 6 mg/kg daily.
Change to oral treatment after improvement:
- Clindamycin, oral, 450 mg 8 hourly for 5 days. PLUS
- Ciprofloxacin, oral, 500 mg 12 hourly.
If patient has severe sepsis, consider urgent hysterectomy.
When the patient is experiencing the following condition, it should refer to specialist immediately;
- Evidence of trauma.
- No response to treatment within 48 hours