59830 Treatment of septic abortion, completed surgically

Name of the Procedure:

Treatment of Septic Abortion, Completed Surgically (also known as Surgical Management of Septic Abortion).

Summary

This surgical procedure removes infected tissue from the uterus after an abortion that has led to a severe infection. It aims to eliminate the infection and prevent further complications.

Purpose

The procedure addresses a septic abortion, a serious infection that occurs when tissue remains in the uterus post-abortion. The goal is to remove the infected tissue, manage the infection, and prevent severe complications such as sepsis or infertility.

Indications

• Persistent fever
• Severe abdominal pain
• Heavy bleeding
• Foul-smelling vaginal discharge
• Positive signs of an intrauterine infection
• Failed medical management of abortion

Preparation

• Fasting may be required for a few hours before the procedure.
• Blood tests, ultrasound, or other imaging studies to assess the extent of infection.
• Antibiotics are often administered before the procedure to control the infection.
• Informed consent discussing the risks, benefits, and alternatives.

Procedure Description

1. Anesthesia: The patient receives general anesthesia or local anesthesia with sedation.
2. Access: A speculum is inserted into the vagina to visualize the cervix.
3. Dilation: The cervix is gently dilated using surgical instruments.
4. Removal: Suction or curettage (scraping) is used to remove infected tissue from the uterus.
5. Inspection: The uterine cavity is inspected to ensure all infected material is removed.
6. Antibiotics: Post-procedure, antibiotics are continued to fully treat the infection.

Duration

Typically, the procedure takes about 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital or a surgical center.

Personnel

• Obstetrician/Gynecologist (OB/GYN) or a specialized surgeon
• Anesthesiologist
• Surgical nurses
• Support staff for immediate post-operative care

Risks and Complications

• Bleeding
• Uterine perforation
• Incomplete removal of infected tissue
• Infection
• Adverse reactions to anesthesia
• Rarely, damage to surrounding organs

Benefits

• Removal of infected tissue eliminates the source of infection.
• Reduction in symptoms such as pain and fever.
• Prevention of severe complications like sepsis or infertility.
• Typically, benefits can be realized immediately after the procedure.

Recovery

• Patients may experience cramping and light bleeding for a few days.
• Pain management includes prescribed medications.
• Follow-up appointments to ensure complete recovery.
• Avoid strenuous activities and sexual intercourse for a period recommended by the doctor.
• Monitoring for signs of persistent or new infections.

Alternatives

• Medical management with antibiotics alone, if the infection is mild.
• Waiting for spontaneous resolution in very rare and mild cases.

Pros of Surgical Management:

• Immediate removal of infected tissue.
• Quick resolution of infection and symptoms.

Cons of Surgical Management:

• Requires anesthesia.
• Invasive procedure with associated risks.

Pros of Medical Management:

• Non-invasive.
• Avoids anesthesia-related risks.

Cons of Medical Management:

• May not be effective in severe cases.
• Prolonged infection can lead to complications.

Patient Experience

Patients will experience some discomfort during and after the procedure, which is managed with pain relief medications. Feeling tired or groggy can be expected post-anesthesia. Emotional support is crucial as this can be a distressing experience.