Family, Internal Medicine, General Medical Questions/Incomplete-Septic Miscarriage

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Question
Some time ago I saw a TV show where a pregnant woman's baby died but her body failed to expel the fetus. In the TV show, the woman had no pain and no bleeding. In a few days she developed a fever, and the main characters had to scramble because that meant she had developed septicemia and would die in a matter of hours if not treated immediately.

I know that a great-great-aunt of mine died because of a similar situation (although I couldn't get more information besides 'she died because her baby died inside her'), so I've searched the net for information. Unfortunately, most hits were for women who had experienced the situation and were themselves looking for answers, but resorting to wikipedia and other general-medicine-informantion sites, I gathered that if the pregnant woman has no previous infections (like urinary, etc), the fetus may remain dead inside her for up to 4 weeks before being naturally expelled, which will cause severe bleeding and pain. In all the cases I read, the septic conditions set in after the woman's body tried to expel the dead tissue but failed to do so completely.

Now, I'm a language teacher and I don't feel apt to make 'educated guesses' on medical issues to go about saying the episode was complete rubbish (it could be based on rare situations, not on the usual ones I've read about). I'd like to know what is and isn't rubbish. So: can a woman not know the baby is dead and develop septicemia without having the slightest cramping or bleeding? And (this is what I'm more inclined to think 'rubbish', but then I've read of women who die of puerperal fever one or two days after giving birth so perhaps it's not rubbish at all) is it really a matter of hours before the infection starts and unavoidable death?

P.S.: Sorry for the long question, but I've been told before 'to do my homework first' so... that's my homework above.

P.P.S.: if you do not answer such 'is the TV show right?' questions, please consider saying so in your profile (some experts welcome it while others seem to be upset, and it's not always easy to guess from profiles). Thank you.

Answer
in general, the uterus and pregnancy contents are sterile.... so no bacterial infection and people can miscarry and eventually expel the contents after days or weeks.   Sometimes a D&C is needed because they aren't coming out on their own.    But the cervix provides an opening for an infection to get in and if that happens, then the uterus contents can become infected and that can be a pretty severe infection and becomes a medical emergency.    So, it can go either way, but typically does not happen immediately, more like a few weeks.......    I hope that answers your questions.

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Robert Borucki

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I am an expert in Family Medicine and Emergency Medicine.

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I am trained and boarded in Family Medicine and have also worked extensively in emergency medicine for over 10 years.

BA in Natural Sciences; MD in 1986

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