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Re: Septic abortion and death (long case) From: savaris@orion.ufrgs.br Mon Dec 15 12:27:32 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: GIN11153@aol.com: "MD Consult website for research" Previous message: Dean Huffman: "Re: Recusal Sought in Florida Med-Mal Case" In reply to: Richard Chudacoff, MD: "Re: Septic abortion and death (long case)" Next in thread: Dr. Ainsworth: "Re: Septic abortion and death (long case)" I discuss the case this mornign in the grand round And here is my question. Where is the evidence for antibiotics for incomplete or missed abortion. Based on cochrane (although one of the professors said: You can not trust cochrane for these things, you should talk to a african doctor, because they have more experience with septic abortion) Antibiotics for incomplete abortion (Cochrane Review) May W, Gülmezoglu AM , Ba-Thike K Background: Unsafe abortions result not only in costs for acute care but may also be responsible for longer-term complications such as pelvic inflammatory disease, damage to reproductive organs, and secondary infertility. If effective, antibiotic prophylaxis at the time of the procedure can potentially prevent these adverse consequences. Objectives: The value of routine antibiotics before surgical evacuation of the uterus in women with incomplete abortion is controversial. In some health centres antibiotic prophylaxis is advised; in others antibiotics are only prescribed when there are signs of infection. The objective of this review is to evaluate the effectiveness of routine antibiotic prophylaxis to women with incomplete abortion. Search strategy: We searched the Cochrane Controlled Trials Register, MEDLINE and Popline. Date of last search: January 1999. Selection criteria: Randomised trials comparing a policy of routine antibiotic prophylaxis with no routine prophylaxis were eligible for inclusion. Data collection and analysis: Data extraction was conducted by two reviewers independently. Trial quality was assessed. Main results: One study involving 140 women was included. A second well- conducted trial was excluded because of high losses to follow-up. No differences were detected in postabortal infection rates with routine prophylaxis or control. However, compliance with antibiotic treatment was also low. Reviewers' conclusions: There is not enough evidence to evaluate a policy of routine antibiotic prophylaxis to women with incomplete abortion. Citation: May W, Gülmezoglu AM , Ba-Thike K. Antibiotics for incomplete abortion (Cochrane Review). In: The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd. -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Citando "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>: -------------------------------------------------------------------------------- > 1. Treat for signs of infection only > 2. Treat for signs of infection only > 3. Send them to Planned Parenthood (least I get shot....they shot horses > here, too, in Dubyaland, don't they?). But if I were to do them, (and I'm > not saying I do) Cipro and Doxycycline or Cipro and Zithromax within 12 > hours of the procedure. > > Richard Chudacoff, MD > > I know war as few other men now living know it, and nothing to me is more > revolting. I have long advocated its complete abolition, as its very > destructiveness on both friend and foe has rendered it useless as a method > of settling international disputes. > Ernest Hemingway > > -----Original Message----- > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Garry E. > Siegel, M.D. > Sent: Sunday, December 14, 2003 8:33 PM > To: Multiple recipients of list OB-GYN-L > Subject: Re: Septic abortion and death (long case) > > At Sun, 14 Dec 2003, Richard Chudacoff, MD wrote: > > > >Yes, but not incomplete or missed Abs. These did not need prophylaxis. > >Treatment, maybe but not prophylaxis. > > > >-- > >Richard Chudacoff, MD > > > OK, so what do you guys do with respect to antibiotics for: > > 1. Planned D and Cs for missed Ab. > 2. D and C for incomplete Ab. > 3. D and C for first trimester termination. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA > ------------------------------------------------- This mail sent through IMP: http://horde.org/imp/ ------------------------------------------------- Next message: GIN11153@aol.com: "MD Consult website for research" Previous message: Dean Huffman: "Re: Recusal Sought in Florida Med-Mal Case" In reply to: Richard Chudacoff, MD: "Re: Septic abortion and death (long case)" Next in thread: Dr. Ainsworth: "Re: Septic abortion and death (long case)"

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