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A randomised comparison of strategies for reducing infective complications of induced abortion.
Br J Obstet Gynaecol. 1998 Jun; 105(6):599-604.BJ

Abstract

OBJECTIVES

To determine lower genital tract carriage rates of C. trachomatis, N. gonorrhoeae and bacterial vaginosis among women seeking termination of pregnancy. To compare two clinical management strategies for minimising the risks of infective morbidity after induced abortion.

DESIGN

Prevalence of infections was assessed by screening women undergoing abortion. Clinical management strategies were compared by a randomised trial.

SETTING

The gynaecology departments of four hospitals in Scotland.

PARTICIPANTS

1672 women undergoing induced abortion.

INTERVENTIONS

Women randomised to prophylaxis received metronidazole 1 g rectally before abortion plus doxycycline 100 mg twice daily for seven days. Women randomised to screen-and-treat received appropriate antibiotics only if screening proved positive for one or more infection.

MAIN OUTCOME MEASURES

Prevalences of infections; morbidity in the eight weeks following abortion as assessed by reported symptoms, general practitioner consultation and prescription rates and hospital re-attendances; costs to the NHS of alternative managements.

RESULTS

Prevalence rates: C. trachomatis 5.6%; N gonorrhoeae 0.19%; bacterial vaginosis 17.5%. Overall, women allocated to receive prophylaxis had lower rates of measures of short term infective morbidity than those allocated to screen-and-treat. These differences only reached statistical significance for women who were reported negative on screening. The direct costs to the NHS of prophylaxis and screen-and-treat were calculated to be 8.17 and 18.34 per woman, respectively.

CONCLUSIONS

Prevalences of lower genital tract infections which have been implicated in increased rates of infective morbidity after abortion are similar to those reported elsewhere. Universal antibiotic prophylaxis is at least as effective as a policy of screen-and-treat in minimising the risk of short term infective morbidity and is far more cost efficient.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9647149

Citation

Penney, G C., et al. "A Randomised Comparison of Strategies for Reducing Infective Complications of Induced Abortion." British Journal of Obstetrics and Gynaecology, vol. 105, no. 6, 1998, pp. 599-604.
Penney GC, Thomson M, Norman J, et al. A randomised comparison of strategies for reducing infective complications of induced abortion. Br J Obstet Gynaecol. 1998;105(6):599-604.
Penney, G. C., Thomson, M., Norman, J., McKenzie, H., Vale, L., Smith, R., & Imrie, M. (1998). A randomised comparison of strategies for reducing infective complications of induced abortion. British Journal of Obstetrics and Gynaecology, 105(6), 599-604.
Penney GC, et al. A Randomised Comparison of Strategies for Reducing Infective Complications of Induced Abortion. Br J Obstet Gynaecol. 1998;105(6):599-604. PubMed PMID: 9647149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomised comparison of strategies for reducing infective complications of induced abortion. AU - Penney,G C, AU - Thomson,M, AU - Norman,J, AU - McKenzie,H, AU - Vale,L, AU - Smith,R, AU - Imrie,M, PY - 1998/7/1/pubmed PY - 1998/7/1/medline PY - 1998/7/1/entrez KW - Abortion, Induced--complications KW - Chlamydia KW - Developed Countries KW - Diseases KW - Europe KW - Examinations And Diagnoses KW - Family Planning KW - Fertility Control, Postconception KW - Gonorrhea KW - Infections KW - Measurement KW - Northern Europe KW - Pelvic Inflammatory Disease--prevention and control KW - Postabortion KW - Prevalence KW - Prospective Studies KW - Reproduction KW - Reproductive Tract Infections KW - Research Methodology KW - Research Report KW - Scotland KW - Screening KW - Sexually Transmitted Diseases KW - Studies KW - Treatment--cost KW - United Kingdom SP - 599 EP - 604 JF - British journal of obstetrics and gynaecology JO - Br J Obstet Gynaecol VL - 105 IS - 6 N2 - OBJECTIVES: To determine lower genital tract carriage rates of C. trachomatis, N. gonorrhoeae and bacterial vaginosis among women seeking termination of pregnancy. To compare two clinical management strategies for minimising the risks of infective morbidity after induced abortion. DESIGN: Prevalence of infections was assessed by screening women undergoing abortion. Clinical management strategies were compared by a randomised trial. SETTING: The gynaecology departments of four hospitals in Scotland. PARTICIPANTS: 1672 women undergoing induced abortion. INTERVENTIONS: Women randomised to prophylaxis received metronidazole 1 g rectally before abortion plus doxycycline 100 mg twice daily for seven days. Women randomised to screen-and-treat received appropriate antibiotics only if screening proved positive for one or more infection. MAIN OUTCOME MEASURES: Prevalences of infections; morbidity in the eight weeks following abortion as assessed by reported symptoms, general practitioner consultation and prescription rates and hospital re-attendances; costs to the NHS of alternative managements. RESULTS: Prevalence rates: C. trachomatis 5.6%; N gonorrhoeae 0.19%; bacterial vaginosis 17.5%. Overall, women allocated to receive prophylaxis had lower rates of measures of short term infective morbidity than those allocated to screen-and-treat. These differences only reached statistical significance for women who were reported negative on screening. The direct costs to the NHS of prophylaxis and screen-and-treat were calculated to be 8.17 and 18.34 per woman, respectively. CONCLUSIONS: Prevalences of lower genital tract infections which have been implicated in increased rates of infective morbidity after abortion are similar to those reported elsewhere. Universal antibiotic prophylaxis is at least as effective as a policy of screen-and-treat in minimising the risk of short term infective morbidity and is far more cost efficient. SN - 0306-5456 UR - https://www.unboundmedicine.com/medline/citation/9647149/A_randomised_comparison_of_strategies_for_reducing_infective_complications_of_induced_abortion_ L2 - https://medlineplus.gov/gonorrhea.html DB - PRIME DP - Unbound Medicine ER -