Metronidazole Prophylaxis in Elective First Trimester Abortion

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In a double-blind controlled trial, the efficacy of prophylactic metronidazole in elective first trimester abortions was assessed. Of 119 randomized women, 100 followed the protocol. Fifty-one women received 400 mg metronidazole one hour before and again four and eight hours after abortion; 49 women received a placebo. In the placebo group 20.4% contracted postabortal genital infection compared with 3.9% in the metronidazole group (P<.025). Of 25 women with a positive history of pelvic inflammatory disease, six contracted postabortal infection, which was a significantly increased frequency compared with women without previous episodes of pelvic inflammatory disease (P<.05). The administration of prophylaxis, however, did not significantly influence the frequency. The number of hospital days was not significantly lower in the prophylaxis group (P>.05). The total amount of metronidazole prescribed in the study group was significantly larger than in the placebo group (P<.05), whereas the amount of ampicillin/ pivampicillin prescribed in the placebo group was significantly larger (P<.05). The difference between the penicillin doses given in the treatment and placebo groups was not significant (P>.1). (Obstet Gynecol 65:371, 1985)

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