Metronidazole and prostaglandin induced abortion

Since the majority of patients requesting induced abortion are nulliparous, it is important that the procedure not endanger future fertility. Infection and uterocervical trauma are 2 possible abortion-related complications which might affect furture fertility. A clinical study was conducted to assess the efficacy of prophylactic use of an antibiotic as a routine accompaniment of induced abortion. Patients selected for the study had been accepted for elective 1st-trimester abortion under the 1967 British Abortion Act. All were aborted with intrauterine extraamniotic PG(prostaglandin) administration supplemented by curettage. 142 of the women received no prophylactic; 145 received 1200 mg metronidazole by mouth 2 hours before the procedure and 400 mg 3 times daily for 2 days thereafter. Population characteristics in the 2 groups were comparable. 24% of the nonantibiotic group as compared to only 4% of the antibiotic group developed postoperative pyrexia. 12% in the nonantibiotic group as compared to 2% of the antibiotic group developed vague symptoms suggestive of pelvic sepsis or of incompleted evacuation. There was no evidence of cervical or uterine trauma in either group. It is concluded that prophylactic antibiotics should be administered with pregnancy termination procedures.