Diagnosis and management of complications of abortion
Symptoms and signs	Complication	Management
• Lower abdominal pain • Rebound tenderness • Tender uterus • Prolonged bleeding • Malaise • Fever • Foul-smelling vaginal discharge • Purulent cervical discharge • Cervical motion tenderness	Infection/sepsis	Begin antibiotics1 as soon as possible before attempting manual vacuum aspiration
• Cramping abdominal pain • Rebound tenderness • Abdominal distension • Rigid (hard and tense) abdomen • Shoulder pain • Nausea/vomiting • Fever	Uterine, vaginal or bowel injuries	Perform a laparotomy to repair the injury and perform manual vacuum aspiration simultaneously. Seek assistance, if required
1 Give antibiotics until the woman is fever-free for 48 hours • Ampicillin 2 g IV every 6 hours • Plus gentamicin 5 mg/kg body weight IV every • 24 hours • Plus metronidazole 500 mg IV every 8 hours