Incidence of uterine post abortion infection at Hospital de Clínicas de Porto Alegre. Is prophylactic antibiotic necessary?

Abstract

ABSTRACT ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature. MethodsMethods Methods Methods Methods: we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH). Results Results ResultsResults Results: of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively. Conclusion Conclusion Conclusion Conclusion Conclusion: The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4).

Antibiotic Prophylactics on Curettage for Preventing Pelvic Inflammatory Disease Events: Is It Necessary?

“…Consideration to give antibiotic prophylaxis is for the patient which have the endocarditis or endophthalmitis risk. In general, the antibiotic is not effective to prevent PID after curettage [22,23]. A study in 67 women, 1 month after an endometrial curettage, PID occurs in four women from intervention group who received doxycycline 200 mg daily for 1 week after the procedure and three women from the control group who did not receive any antibiotic regimen (p>0.05) [24].…”

Urgências e Emergências Infecciosas na Gestação

“…Estima-se que entre 1990 e 2008 ocorreram, a cada ano, 47 mil mortes maternas no mundo devido ao aborto não seguro, sendo a infecção a principal causa dessas mortes. Esse número corresponde a cerca de 13% das mortes maternas (PANKE et al, 2014).…”

“…Em um trabalho de coorte retrospectivo entre 2008 e 2012, Panke et al (2014) observaram que as pacientes que eram internadas com o diagnóstico de aborto infectado, eram também mais jovens, com prevalência maior de Vírus da Imunodeficiência Humana (HIV) em 5,7% e com menores níveis de hemoglobina, em relação às que internavam sem a infecção.…”