Fulminant Peritonitis Following Second Trimester Spontaneous Abortion; Case Report, 2023

Background: Sepsis Following Abortion Is Usually a Feature of Induced Abortion, Especially When It Is Performed Under Unhygienic Conditions And By Untrained Person. Although Extremely Rare, Spontaneous Abortions Can Result Into Severe Sepsis And Endanger Life of the Pregnant Woman. Case Report: A 30 year old multiparous mother was admitted with history of spontaneous abortion at 18 weeks gestation at nearby hospital in teseney, eritrea on 21/03/2022. It was planned pregnancy that ended up in inevitable abortion which was attended by general practitioners and midwives in the hospital and discharged after 48 hours. A week later, on 28/03/2022, she was re-admitted again with a complaint of diffuse abdominal pain, distention and shortness of breath. Despite a week course of broad spectrum antibiotics in the hospital, abdomen was progressively distended, and she was referred to orotta national maternity referral hospital. explorative laparotomy was done and about three liters of serous fluid with foul smelling debris was evacuated from the abdomen. Extensive bowel adhesion was found and gentle adhesion lysis was done. parietal peritoneum was red to black in color and uterus and ovaries were found healthy. on postoperative third day, she developed pulmonary embolism and transferred to intensive care unit. after a month of medical and surgical management, she was discharged home with full improvement. Conclusion: The case is presented because of its rarity in regards to primary etiology and severity of sepsis. The onset was acute that may end in death if urgent interventions were not done. Clinicians should high index of suspicion for these rare associations in which the pathogenesis is not yet known.