6.1 INTRODUCTION

Unsafe abortion has a high risk of complications from infection, both from introducing pathogens (micro-organisms) into the uterus and from retained products of conception which make it easy for infection to grow. Localized infection from induced or spontaneous abortion can quickly lead to more generalized sepsis and septic shock, which can be fatal. Therefore, prompt action to stabilize the patient, and remove and treat the source of the infection is needed to save the woman's life. Delay in treatment can be fatal.

Antibiotics and uterine evacuation are often the definitive treatment, but surgical repair of perforated organs and surgical removal of dead tissue and abscesses may also be necessary. Sometimes hysterectomy is the easiest and most suitable solution of the problem. Minor infection can be treated and first trimester uterine evacuation done wherever trained staff and drugs are available. In more complicated cases, antibiotics and fluid replacement must be started IMMEDIATELY. Surgery may be required. Without immediate initiation of treatment and prompt definitive treatment, the patient may die. In cases of renal failure, tetanus, gas gangrene, or where the required care is beyond the capabilities of the facility, referral to a tertiary care centre is imperative.

If uterine evacuation is NOT possible, or if surgery is necessary and is NOT possible, then she should be referred once initial stabilizing steps have been taken.