[Preventive antibiotics in induced first-trimester abortion].

Area of Science:

• Gynecology
• Infectious Diseases
• Public Health

Context:

• Induced abortion carries a 3-5% infection risk.
• Postabortal infections share sequelae with spontaneous pelvic inflammatory disease, including secondary infertility (10%), recurrent spontaneous abortion (22%), dyspareunia (20%), and chronic pelvic pain (14%).
• Surgical procedures occur in a contaminated field, increasing risks from pathogenic bacteria like Chlamydia trachomatis.

Purpose:

• To assess the incidence and sequelae of infection following induced first-trimester abortion.
• To identify risk factors for postabortal infection, including Chlamydia trachomatis.
• To evaluate the efficacy of prophylactic antibiotics in reducing infection rates.

Summary:

• Postabortal infections occur in 3-5% of cases, with significant long-term sequelae.
• Chlamydia trachomatis is a key pathogen, present in 7% of patients, increasing infection risk by 20%.
• Prophylactic antibiotics, particularly tetracyclines, metronidazole, and penicillin/pivampicillin, administered peroperatively, can halve infection incidence. Screening and treating C. trachomatis is recommended.

Impact:

• Reduced infection rates and associated long-term morbidities following induced abortions.
• Optimized antibiotic prophylaxis strategies by targeting at-risk groups.
• Improved patient outcomes through screening and timely treatment of Chlamydia trachomatis infections.