Preoperative Cervical Microbial Flora and Post‐Abortion Infection

Abstract

With the aim to find criteria for the prediction of the patients who are at risk of developing a post-abortion infection the pretreatment cervical microbial flora was compared between one series of patients who developed and another series of patients who did not develop such an infection. Aerobic and anaerobic bacteria as well as mycoplasma and fungi, were studied in 104 patients. The distribution of aerobic and anaerobic bacteria was similar in the 14 patients who later developed post-abortal infection and in uncomplicated cases. It is concluded that the cultivation of the cervical microbial flora cannot serve as a basis for the prediction of which patients will develop subsequent genital infections.

A randomised controlled trial of prophylaxis of post‐abortal infection: ceftriaxone versus placebo

“…The reported frequency of post‐operative pelvic inflammatory disease (PID) is 3 to 20% (Moberg et al 1978; Westergaard et al 1982; Heisterberg et al 1985; Barbacci et al 1986; Giertz et al 1987; Heisterberg & Kringelbach 1987; Levallois & Rioux 1988; Prien‐Larsen & Kjer 1989; Larsson et al 1992; Sørensen et al 1992) and is influenced by the microbial flora of the vagina and cervix. In particular, the presence in the cervix of Chlamydia trachomatis increases the risk of postabortal inflammation (Moberg et al 1978; Westergaard et al 1982; Barbacci et al 1986; Levallois & Rioux 1988; Prien‐Larsen & Kjer 1989; Larsson et al 1992; Sørensen et al 1992). Other bacterial species also may increase the risk of postabortal infection, of which Neisseria gonorrhoeae is the classic example (Heisterberg et al 1985; Prien‐Larsen & Kjer 1989).…”

“…Prophylactic treatment with antibiotics of women at high risk of postabortal PID has been recommended. These risk factors include young age, a history of PID, a positive cervical or urethral culture of C. trachomatis or N. gonorrhoeae , and bacterial vaginosis (Moberg et al 1978; Heisterberg et al 1985; Levallois & Rioux 1988; Larsson et al 1992; Sørensen et al 1992). However, the value of prophylaxis in women without risk factors is less clear.…”

Is preoperative vaginal cleansing necessary for control of infection after first trimester vacuum curettage?

“…Vacuum aspiration has been the preferred technique for the interruption of first trimester pregnancy since almost half a century and it still is, even though in Sweden medically induced abortions have gained popularity during the last decade and in 2002 constituted 44% of the abortions. The frequency of postabortion pelvic inflammatory disease (PID) ranges between 1 and 17% in various studies (1–4). Postabortion PID is usually associated with short‐term morbidity, but sometimes with long‐term sequelae as tubal infertility and ectopic pregnancy (5).…”