Bacteriologic studies in second-trimester pregnancy termination: a comparison of intra- and extra-amniotic methods

Vaginal and cervical cultures were obtained in 20 women undergoing intra-amniotic saline infusion and 20 women having extraamniotic saline infusion for second-trimester abortion. Following expulsion intrauterine cultures were taken and the patients were followed for signs of clinical infection. Sixty percent of the patients had pathogenic bacteria cultured intrauterine cultures after abortion and 7.5% had clinical infection. There was a positive correlation between infection-abortion time and pathogenic intrauterine cultures. No significant differences in the incidence of positive intrauterine cultures or clinical infection between the two groups were found. Of those patients with positive preabortion cultures 70% had identical pathogens cultured from the uterus after expulsion suggesting that most postabortal pathogens arise from endogenous vaginal and cervical sites rather than from exogenous sources.