During the course of any abortion, spontaneous or induced, infection may set in.

Such infections are characterized by fever, chills, uterine tenderness and occasionally, peritonitis. The responsible bacteria are usually a mixed group of Strep, coliforms and anaerobic organisms. These patients display a spectrum of illness, ranging from mild, to very severe.

Usual treatment consists of bedrest, IV antibiotics, uterotonic agents, and complete evacuation of the uterus. If the patient does not respond to these measures and is deteriorating, surgical removal of the uterus, tubes and ovaries may be life-saving.

Evacuation of the uterus can be initiated with oxytocin, 20 units (1 amp) in 1 Liter of any crystalloid IV fluid at 125 cc/hour or ergonovine 0.2 mg P.O. or IM three times daily. If the patient response is not favorable, or if the patient is quite ill, D&C is the next step.

IV antibiotics should be started immediately. Among many good choices for this treatment are:

Ampicillin 2 gm IV Q6 hours, plus 
Gentamicin 1-1.5 mg/kg IV Q8 hours, plus 
Clindamycin 900 mg IV Q8 hours

Another good choice could be:

Imipenem-cilastin 250-500 mg IV Q6 hours, or

Aztreonam 1-2 gm IV Q12 hours, plus
Metronidazole 1 gm IV loading dose, then 500 gm IV maintenance dose