Incidence of uterine post abortion infection at Hospital de Clínicas de Porto Alegre. Is prophylactic antibiotic necessary?

OBJECTIVE: To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature.METHODS: we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH).RESULTS: of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively.CONCLUSION: The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4).

【研究目的】明确巴西南部一所三级医院中，流产患者接受子宫清除术后盆腔感染的发生率，并与国际相关文献进行对比。【研究方法】回顾性分析阿雷格里港临床医院（Hospital de Clinicas de Porto Alegre）2008年8月至2012年1月期间所有因流产接受子宫清除术的患者电子病历。纳入所有因流产行刮宫术且术后接受门诊随访的患者，计算研究人群的人口学与实验室数据、治疗所需人数（number needed for treatment, NNT）及伤害所需人数（number needed to harm, NNH）。【研究结果】本次共回顾857份电子病历，其中377例患者因流产接受子宫清除术；55例失访，最终纳入322例入院时未合并感染性流产的病例。研究人群以白人为主（79%）；人类免疫缺陷病毒（Human Immunodeficiency Virus, HIV）感染率为0.3%，梅毒性病研究实验室试验（Venereal Disease Research Laboratory test, VDRL）阳性率为2%。对该322例患者进行至少7天的随访后发现，术后感染发生率为1.8%（95%置信区间（confidence interval, CI）0.8~4）。本研究计算得出42个月随访周期内的NNT为63，NNH为39。【研究结论】2008年8月至2012年1月期间，流产术后感染发生率为1.8%（95%置信区间0.8~4）。