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The World Health organization (WHO) recommends antibiotic prophylaxis to prevent infectious complications associated with abortions. Several studies have shown that pre-abortion treatment for BV is effective in reducing the rate of postabortal infections. These patients had not received any prophylactic antibiotics. They reported infections among 4.8% of the patients. Another study conducted in Sweden and Norway investigated the infection rate after surgical abortions. They reported a frequency of 2.4% for infectious complications from medical abortions and 4.9% from surgical abortions. In Skaraborg, where the present study takes place, the number of postabortal infections was evaluated by Charonis and Larsson in 2006. The reported incidence of postabortal infections varies between studies, likely depending on local differences in diagnostics, the study population, laws and regulations, and the prevalence of sexually transmitted diseases. The infection, if untreated, can spread to the fallopian tubes and may lead to infertility.
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Infections related to abortions are often caused by an ascending bacterial infection such as chlamydia, gonorrhea, mycoplasma and bacterial vaginosis (BV) that proceeds from the lower genitals and moves through the cervix to the uterus. Of the 24,006 adult participants who underwent a medical abortion, 15.4% were later diagnosed with bleeding, 2.0% experienced an infection, 10.2% experienced an incomplete abortion, and 13.0% had to proceed with a vacuum curettage. investigated the rate of complications related to medical abortions. Potential complications related to abortions include pain, bleeding, an incomplete abortion, or an infection in the upper genital tract that causes endometritis, oophoritis, parametritis, and salpingitis. Before that, surgical abortions were the only legal option < 12 gestational weeks.ĭespite well-developed abortion methods, there are known risks and adverse effects that must be considered. Early medical abortions (< 9 weeks of gestation) were introduced in Sweden 1992 when Mifepristone became available. The most common method was a medical abortion, which was used in 88% of all cases. The rate of abortions was women by the age of 15–44. The majority (93%) of which, were performed before the 12th week of pregnancy. There were 36,600 induced abortions reported to The National Board of Health and Welfare (Socialstyrelsen) during 2014.
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The screening process seems to fulfill its purpose of reducing the risk of infectious complications.Īn induced abortion is one of the most common gynecological procedures in Sweden. Women who tested positive for one or several bacteria upon screening and received antibiotics experienced almost an equal proportion of postabortal infections compared to women who tested negative upon screening. The share of complications related to medical abortions < 12 weeks increased significantly during 2008–2015 without any evident cause. Among those who tested negative at the screening, 1.7% developed infectious complications. Of all women who tested positive for one or several bacteria at the screening and therefore received antibiotics, 1.4% developed a postabortal infection. An incomplete abortion was the most common complication related to medical abortions < 12 weeks. Among medical abortions < 12 weeks, the complication frequency increased significantly, from 4.2% in 2008 to 8.2% in 2015 (RR 1.49, 95% 1.04–2.15). Complications were registered in 333 (6.7%) of all abortions. Nearly all, 4945 (99.7%) were eligible for inclusion in the study. ResultsĪ total of 4945 induced abortions were performed during the study period. Abortion complications, categorized as bleeding, infection, or incomplete abortion were assessed in women who came in contact with the gynecological clinic within 30 days after the procedure. Bacterial screening for chlamydia, gonorrhea, mycoplasma, and bacterial vaginosis was performed prior to the abortions. MethodsĪll women who underwent induced abortion at Skaraborg Hospital between 20 are included in the study. The aims of this study are to provide an overview of complications of medical and surgical abortions and to evaluate the impact of bacterial screening to prevent postabortal infections. Induced abortion is one of the most common gynecological procedures in Sweden, but there is still little knowledge about the adverse effects.