1996: Endocarditis, infarcts, bacteremia and coronary artery embolism

In 1996, a report was submitted to a medical journal on a maternal abortion death. The unidentified woman referred to here as “Anne Roe” was 32 and pregnant with her sixth baby. She had already had two births with no noted complications and three abortions. There were no significant conditions in her medical history.

A few weeks before her own death, Anne underwent her fourth and final abortion. No complications were noted at the time, but Anne soon went to her usual doctor because of a fever, chills, yellow discharge and other symptoms. She hadn’t told the doctor about her recent abortion, possibly believing that she didn’t need to. She was given antibiotics and told to return in a week for followup, but she only became worse. Only 2 weeks after the abortion, she was in the emergency room.

At the ER, Anne was still suffering from all of the earlier symptoms and now leg pain. Various tests were performed, but doctors were having trouble finding the location of the infection. After examination and IV treatments, she was admitted to the ward service. At the time she was awake, aware and alert.

Only 2 hours later, Anne’s condition massively deteriorated. She was found in severe respiratory distress. A CPR team rushed to treat her, but by the time they arrived she had no pulse and was unresponsive. She was put on life support and resuscitation was attempted for 67 minutes, but she was declared dead.

Her autopsy identified the cause of death. In an unusual case, Anne had died of bacterial endocarditis from a septic coronary artery embolism. She also had embolic infarcts in her right kidney and her spleen. It was concluded that the abortion resulted in group B streptococcus bacteremia and the subsequent development of endocarditis.

The study noted that after elective abortion, “complications of endocarditis are common.” The only unusual part of Anne’s case was the septic embolism of a coronary artery. Although septic infections, embolisms and endocarditis are common among maternal deaths from abortion, this specific combination of the three was not.

Medical journal report