2 large bore IVs; aggressive IV fluid resuscitation
Assess for and control any vaginal bleeding
Broad-spectrum antibiotics – ampicillin 1-2 gm IV + gentamicin 1-2mg/kg IV + clindamycin 600-900mg IV or metronidazole 500mg IV
Tetanus vaccination
Early OB consult – Most will need evacuation of any remaining products of conception
Early surgery consult - Exploratory laparotomy if any pelvic free fluid or intra-abdominal air
Septic abortion
The same abdominal pain differential as non-pregnant patients, plus:
Chorioamnionitis
Ectopic pregnancy
Postpartum endometritis
First trimester abortion
Placenta accreta
Complete abortion