Comprehensive Interpretation of infectious abortion

Infectious pathogens abortion is often the vagina or intestinal tract filum (opportunistic pathogen), sometimes mixed infections. [Clinical manifestations]

In addition to various types of abortion patients in the clinical manifestations and history of illegal abortion, but also there was a series of symptoms and signs of infection.

1. The general clinical manifestations of infection chills fever, increased pulse quickly, nausea and vomiting.

2. Abdominal pain usually manifested in the lower abdomen or pelvic area of persistent pain;

Emotional abortion vagina or intestinal pathogens is often the filum (opportunistic pathogen), sometimes mixed infections. Anaerobic infection accounted for more than 60% common are the anaerobic Streptococcus, Bacteroides, Clostridium and so on. Aerobes in the E. coli bacteria as the more common and false buds, but also saw p hemolytic streptococcus and enterococcus infections.

[Clinical manifestations] In addition to various types of abortion patients in the clinical manifestations and history of illegal abortion, but also there was a series of symptoms and signs of infection.

1. The general clinical manifestations of infection chills fever, increased pulse quickly, nausea and vomiting.

2. Abdominal pain usually manifested in the lower abdomen or pelvic area of persistent pain; when there is diffuse peritonitis abdominal pain may spread to the whole.

3. Leucorrhea abnormal increase in the volume leucorrhea, often purulent, or pus and blood, there has been the smell.

4 gynecological examination the cervix can be seen out of purulent secretions, cervical pain, give clear uterus tenderness, annex area thickening or painful mass.

5. Peritonitis signs in the lower abdomen or whole abdomen with tenderness, rebound tenderness and muscle Wei.

[Auxiliary]

1. Routine blood test elevated white blood cell count high rate of l neutrophils.

2. Coagulation function test

Septic abortion can be further complicated by disseminated intravascular coagulation (DIC); at this time shows abnormal coagulation parameters, such as out, clotting time, platelet count, fibrinogen, prothrombin time, “3P”test abnormalities.

3. Pathogens

Cervical secretion smears done directly to find pathogenic Gram stain. Blood, cervical canal or the bureaucratic contents do anaerobic and aerobic training can be seen the growth of bacteria. Culture drug sensitivity test should be done at the same time.

4. X-ray examination

Uterine perforation, or visceral perforation occurred when doing the chest, abdomen, or radiography can be seen perspective subphrenic pneumoperitoneum. Aerogenes pelvic infection can be seen the plot gas, serious changes in the formation of honeycomb.

5. Other blood gas analysis should be done in severe cases, water, electrolytes and renal function tests.

[Diagnostics]

Based on the clinical manifestations and laboratory examinations, the diagnosis of infectious abortion is not difficult. Abortion should be made to pathogen infection diagnosis, in addition, attention should be paid the diagnosis of complications, such as septic shock, acute renal failure, D1C and so on.

[Therapy] principle of treatment is rapid uterine contents infection control, prevention and treatment of complications.

(A) treatment measures

Removed as soon as possible

1. Infection control

According to disease severity and the decision to use antibiotics, the antibacterial spectrum of drug type, dosage and route of administration. In the pathogenic bacteria and drug sensitivity test is not explicitly prior to the use of broad-spectrum antibiotics or combination therapy. Commonly used in combination therapy programs are the following. Pathogen susceptibility test clearly an option to 1-3 kinds of sensitive antibiotics.

(1), penicillin G (1000 Wan -2,000 million U / d), gentamicin (160,000-247Y / d).

(2) Vanguard ADM Ⅵ (2-3 / d), metronidazole (] -2 Kuang d).

(3) New penicillin Ⅱ (4-6 Kuang d), gentamicin (160,000 -24 ~ / 3 / d).

(4), erythromycin (2 Kuang d), chloramphenicol (2 Kuang d).

2. Surgery

The potential risk of infectious abortion is Gan Ranzao proliferation, concurrent septic shock, acute renal failure, DIC and other serious complications. Early surgery should therefore be to remove the pathogens.

(1) of the Qing surgery: In the antibiotic therapy, based on the stable condition were advised to prepare for clean government. Can first use preoperative uterine agent (intravenous or intramuscular injection), to prevent uterine perforation. Surgery when the first general officer with the oval cavity clamp pliers out of large organizations, using a curette Saogua palace walls a week of infection-prone fragile uterus uterine perforation, it is best experienced doctors surgery facilities. In addition, the Qing surgery is accelerating the spread of blood-borne bacteria risk of postoperative anti-infective therapy should be strengthened, and the attention to the guardianship of vital signs.

(2) hysterectomy: Generally speaking, infectious abortion in removing infected embryonic tissue after inflammatory multi-energy control, but there are also individual cases is difficult to control inflammation, which causes septic shock, ‘both failure and DIC, etc. , and also prove the existence of uterine perforation or serious infection of the uterus should be considered in real terms to do hysterectomy.

3. Supportive care

Cases of severe infection should be rehydration to correct water-electrolyte balance, blood transfusion and transfusion of human albumin, supplementary heat, so as to enhance the body resistance and surgical tolerance.

(B) complications of treatment

Abortion severe infection may be complicated by septic shock, acute renal failure, DIC, pelvic thrombophlebitis Yandeng serious complications, clinical attention should be paid on the early prevention and treatment.