Conservative management of clostridial endometritis.
OBJECTIVE
Clostridial infection during pregnancy may rapidly progress to life-threatening sepsis. This danger could prompt clinicians to consider hysterectomy as a treatment option as soon as clostridial infection becomes highly suspect or is confirmed, irrespective of its clinical severity. We present evidence that conservative management with the use of intravenous antibiotics is a reasonable initial treatment choice in women undergoing induced abortion who show no sign of sepsis.


METHODS
We describe the conservative treatment and epidemiologic investigation of unsuspected, culture proven clostridial infections in 5 women undergoing dilation and evacuation abortion during a 22-month period and review the existing literature.


RESULTS
Prompt administration of broad-spectrum parenteral antibiotics successfully treated 5 healthy, stable women with culture proven uterine or blood stream clostridial infections.


CONCLUSIONS
Intravenous broad-spectrum antibiotics with close surveillance is a reasonable initial treatment choice after atraumatic uterine evacuation for women with known or suspected clostridial infection that manifests no sign of sepsis.
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, IL, USA.
E Steve
ES
Lichtenberg
Chynel
C
Henning
D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy*; D002981:Clindamycin / Q000008:administration & dosage; D003015:Clostridium Infections / Q000188:drug therapy* / Q000453:epidemiology; D004107:Dilatation and Curettage; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D004716:Endometritis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D007795:Laminaria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D013407:Sulbactam / Q000008:administration & dosage
D005839:Gentamicins; D002981:Clindamycin; D000667:Ampicillin; D013407:Sulbactam