Septic shock after intracervical laminaria insertion.
OBJECTIVE
Laminaria placement is seldom thought to be associated with postabortal sepsis.


METHODS
A nulliparous woman presented with high fever, low blood pressure, and signs of infection during artificial legal abortion with laminaria placement for cervical dilatation. Broad-spectrum antibiotics were given. Cultures of blood, placenta, and arterial line all yielded Enterobacter cloacae. The patient responded to antibiotics and supportive care.


CONCLUSIONS
The use of laminaria still places patients at risk for infection because there is a certain risk of ascending colonization with potentially pathogenic microorganisms from the vaginal and cervical microflora, as in our patient. Surgical disinfection, prophylactic antibiotics, and shortened duration of laminaria placement are helpful to prevent infectious insult. Once signs of infection are noted, physicians should take action as soon as possible, such as initiating broad-spectrum antibiotics and intensive care.
Lin
Shin-Yu
SY
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Cheng
Wen-Fang
WF
Su
Yi-Ning
YN
Chen
Chi-An
CA
Lee
Chien-Nan
CN
D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D002443:Ceftriaxone / Q000627:therapeutic use; D002584:Cervix Uteri; D016972:Enterobacter cloacae; D004756:Enterobacteriaceae Infections / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007795:Laminaria; D011247:Pregnancy; D012772:Shock, Septic / Q000209:etiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone