Chapter 22: Helping a woman after a pregnancy ends early
To help a woman with an infection
• If she still has tissue in her womb, the infection will not get better until
the tissue is removed. Use one of the methods on pages 407 and 408 to
empty the womb.
• Give antibiotics (see below).
• Read page 411 for how to prevent tetanus infection.
• Help the woman drink lots of fluids. This will help the body fight infection. If
she has a hard time drinking, give her rehydration drink (page 160),
rectal fluids (page 342), or an IV (page 350).
• Help the woman eat nutritious food. Some fresh fruits
like oranges, guava, papaya, mangos, and breadfruit
have vitamin C, which helps fight infections.
• If you know how to use plant medicines to stop
infections, the woman can take them, but do not
put any plant medicines into the womb. (See page 19 for
ideas about how to decide if plant medicines are useful or harmful.)
To treat infection
Get medical help. On the way, give these medicines. For complete information
on these medicines, see the green medicine pages starting on page 463.
• inject 2 g ampicillin.................................................................in the muscle, then reduce the
dose to 1g, 4 times a day
and
• inject 300 mg gentamicin.................................................in the muscle, 1 time a day
(or 5 mg gentamicin for
each kg the woman weighs)
and
• give 400 to 500 mg metronidazole...........................by mouth, 3 times a day
Stop giving these antibiotics when the signs of infection have been gone
for 48 hours. Then start giving doxycycline tablets.
When signs have been gone for 48 hours
• give 100 mg doxycycline ..................................................by mouth, 2 times a day for 10 days
If you cannot inject medicines or you do not have the above medicines
You can give medicines by mouth instead.
• give 3.5 g ampicillin ����������������������������������������������������������������by mouth, 1 time only
and
• give 100 mg doxycycline ���������������������������������������������������by mouth, 2 times a day
for 10 days
410
A Book for Midwives (2010)