Conservative management of clostridial endometritis.

Abstract

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