Who can get a Septic Uterus?
If you are born with female sex reproductive organs you have a uterus and could suffer from maternal sepsis. Maternal sepsis complicates an estimated 10 cases per 10,000 live births in the U.S. and is the country’s second leading cause of pregnancy-related death. It is responsible for 15% of all maternal deaths worldwide.
What Does A ‘Septic Uterus’ describe?
Maternal sepsis, sometimes inaccurately referred to as ‘septic uterus’ is a severe bacterial infection, usually of the uterus, which can occur in pregnant women or more commonly, in the days following childbirth. Infection that occurs just after childbirth is also known as puerperal sepsis.
Bacteria called group A Streptococcus (GAS) are an important cause of maternal sepsis. GAS usually cause mild throat infections and skin infections, or may have no symptoms at all. However, sometimes the bacteria are able to evade the body’s normal defence mechanisms and cause sepsis. Infection may be localised to the uterus or it can spread to involve fallopian tubes and ovaries or into the blood stream.
Maternal sepsis was once a common cause of maternal death but is now rare due to improved hygiene standards and effective antibiotics.
Maternal sepsis causes fever and one or more of the following:
- chills and feeling generally unwell
- lower abdominal pain
- foul-smelling vaginal discharge
- bleeding from the vagina (blood loss may be heavy for the first few days but will gradually become less)
- dizziness and collapse.
If you are pregnant or have recently delivered a baby and you have any of these symptoms you need to seek medical attention urgently.
Where are the risk factors for maternal sepsis?
Risk factors for maternal sepsis include:
- Caesarean section
- Prolonged labour or early rupture of membranes
- Multiple vaginal examinations during labour
- Damaged or dead skin tissue (as a result of traumatic delivery)
- Fragments of placenta remaining in the womb after delivery
- Poor standards of hand washing and general hygiene in the days following delivery
- A sore throat or respiratory illness, or having close contact with someone with this type of illness.
Sepsis is the leading cause of deaths in women giving birth in the UK, so it’s good to be aware of it.
When Does A Septic Uterus Happen?
Women can also develop sepsis if they have a miscarriage, which is sometimes called a “spontaneous abortion” if it occurs before 20 weeks gestation. If that happens, you need to do two things: start antibiotics and clean out the remaining tissue in the uterus with a dilation and curettage (D&C).
Any time surgical instruments are used to perform an abortion, which is necessary for abortions after 10 weeks gestations (pills can be used in the first trimester), there is always the possibility of an infection with risks of infection being much higher for illegal abortions.
There are many bacteria in the vagina which can be introduced into the uterus during the procedure. If a lot of tissue is left in the uterus, an infection can ensue in the remaining tissue. This is can be especially problematic if the person doing the procedure isn’t properly trained.
Why would a women get maternal sepsis?
The risk of getting an infection is increased in the following circumstances:
- After having a miscarriage or a Dilation & Curettage
- Premature rupture of membranes (your waters break long before your baby is due)
- If your waters break more than 18 hours before your baby is born
- If you develop a urine infection (UTI)
- If your baby was born prematurely / early (before its due date)
- After you have had your baby – this is the most common time for serious infection (septic illness) to develop; especially if you had your baby by caesarean section, by forceps or vacuum delivery, or if you had a third degree tear (large tear to your perineum)
Good to know…
With the recent overturning of Roe v. Wade, in the United States of America, there is outrage from women no longer guaranteed the federal right to have an abortion. This has been voiced on social media platforms where people have used ’septic uterus’ which is an inaccurate term, to describe when someone may develop sepsis as the result of a miscarriage or botched abortion to highlight the necessity of legal abortions.
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