Authors:
Crowley T. Low N. Turner A. Harvey I. Bidgood K. Horner P.
Institution:
Dr. T. Crowley, Bristol Royal Infirmary, Milne Sexual Health Centre, Lower Maudlin Street, Bristol BS2 8HW; United Kingdom.
Title:
Antibiotic prophylaxis to prevent post-abortal upper genital tract infection in women with bacterial vaginosis: Randomised controlled trial (2001-3272).
Source:
British Journal of Obstetrics and Gynaecology. Vol 108(4) (pp96-402), 2001.
Abstract:
Objective. To determine the prevalence of bacterial vaginosis in women undergoing first trimester suction termination of pregnancy and to evaluate the efficacy of metronidazole in reducing the risk of post abortal pelvic infection in women with bacterial vaginosis. Design. Randomised double-blind placebo-controlled trial. Setting. Two teaching hospitals and one district general hospital. Sample. Two hundred and seventy-three women with bacterial vaginosis undergoing termination of pregnancy. Methods. Women with bacterial vaginosis, diagnosed using modified Spiegel's criteria, were individually randomised to receive either a 2 g metronidazole suppository or identical placebo per-operatively. Participants, doctors and investigators were blinded to treatment allocation. Participants were asked to complete a questionnaire about post-operative symptoms, visits to the general practitioner, antibiotic treatment, readmission to hospital, contraception and emotional response after one month.
Results:
The prevalence of bacterial vaginosis was 29.3% (326/1111). Intention-to-treat analysis showed that post-operative upper genital tract infection developed in 12/142 (8.5%) women allocated to metronidazole and 21/131 (16.0%) women randomised to placebo, a difference of 7.6% (95% confidence intervals -15.4 to +0.2%; relative risk 0.53, 0.27 to 1.03, P = 0.055). The effect of prophylaxis was similar when the analysis was restricted to women receiving the allocated treatment and with complete follow up. There was no difference in the risk of readmission to hospital and the fre quencies of self reported symptoms in the two groups were similar.
Conclusion:
This randomised placebo-controlled trial among women with bacterial vaginosis provides weak evidence that metronidazole decreases the risk of upper genital tract infection after first trimester suction termination of pregnancy but a chance finding could not confidently be excluded. Large well-conducted randomised trials with long term outcome measures are now needed to determine the most effective antibiotic combinations and strategy for prevention of post-abortal pelvic infection.
Please click on the required question.
- 1 What does the term abortion mean?
- 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
- 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped - e.g. Down Syndrome?
- 3A What is Tay Sachs and should we test for it?
- 4 How prevalent is pregnancy termination?
- 5 Why do unwanted pregnancies occur?
- 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
- 7 Should I terminate my pregnancy for social reasons?
- 8 How can my pregnancy be terminated?
- 9 What does a suction (surgical) termination of pregnancy involve?
- 10 What is a medical abortion?
- 11 What will happen to me if I have a medical abortion?
- 12 How do medical and surgical pregnancy termination compare?
- 13 What are the chances of medical termination failing?
- 14 What are the risks of pregnancy termination?
- 15 Why is there debate about the ethics of pregnancy termination?
- 16 Support Groups.
- 17 Where can I obtain more information?
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