Septic abortion with renal failure treated by hysterectomy

Acute renal failure is a serious and life-threatening complication of septic abortion. The documented mortality rate varies between 30% and 65%. Initial management of the patient with this complication is directed towards resuscitation which should be carried out in an intensive care unit. If significant clinical improvement has not taken place within the first 12--24 hours, then hysterectomy should be considered as an emergency procedure. In 6 of the 7 patients described, it is thought that early hysterectomy was the crucial factor contributing towards their survival. The presence of diffuse intravascular coagulation, which was seen in all our patients, is an added indication for surgical intervention, and its role in the pathogenesis of acute renal failure is discussed.