Post-abortal tetanus

Conn Med. 1975 Dec;39(12):773-4.


PIP: A 19-year-old Negro female, gravida 2, para 1, was presented at the Queen Elizabeth Hospital in Barbados, West Indies with difficulty opening her mouth; bleeding, and spasms of the skeletal muscles. A week before, she had undergone an illegal abortion performed by a friend. Curettage; tracheostomy; and passage of a nasogastric tube under general anesthesia were performed after admission. Antitetanus serus; high doses of diazepam; promazine for sedation; and antibiotics were administered. Curarization; assisted ventilation; and maintenance of nutrition through parental fluids were observed. Bilateral pneumothorax; tachycardia; and hypotension complicated the patient's course. The patient was discharged on the 40th day of hospitalization and was advised to visit the medical and gynecology clinic for follow-up examination and completion of tetanus immunization. Factors critical in the management of postabortal tetanus patients include: 1) recognition of classical signs of trismus; risus sardonicus; dysphagia and increased muscular tone and spasms; 2) use of antitetanus serum after sensitivity testing; 3) antibiotic coverage for clostridia and anaerobic organisms; 4) tracheostomy; curarization and assisted ventilation where necessary; 5) continuous medical and nursing care in a quiet room; 6) adequate hydration and nutrition; 7) treatment of site of injury, and curettage where necessary; 8) hysterectomy where necessary; and 9) post treatment immunization.

MeSH terms

  • Abortion, Criminal*
  • Adult
  • Female
  • Humans
  • Pregnancy
  • Tetanus / etiology*
  • Tetanus / therapy