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Infection rate after medical abortion is very low.

A review of the literature on infection after medical abortion, using data from 65 studies involving 46,421 women, found the overall rate of infection was 0.92%. The review included studies of regimens using mifepristone with gemeprost, mifepristone with oral misoprostol, mifepristone with vaginal misoprostol, methotrexate with vaginal misoprostol, and vaginal misoprostol only. Infection was defined as cases of confirmed diagnosis of infection and also those treated with antibiotics for any reason, including presumptive infection based on the presence of prolonged bleeding, abdominal pain, offensive discharge and/or pyrexia. Thus, the calculated infection rates are likely to be an overestimate.

Of the 429 infections reported, the most common were endometritis (210 cases, 49% of all infections) and undefined genital tract infection (159 cases, 37%). Infections were most common among women who received mifepristone followed by gemeprost (1.56%, n=11,501). Only four cases (0.01%) required hospitalisation. Frequency of infection was significantly higher in the United Kingdom compared to other countries (2.54% vs. 0.28%) but this anomaly may be due to the use of antibiotic treatment as a standard practice for presumptive infection, signalled only by prolonged bleeding or pain. Removing the 13,302 UK medical abortions from the analysis reduced the overall frequency of infection from 0.92% to 0.28% and with this, differences in rates of infection between the various regimens disappeared. Thus, infection risk after medical abortion is very low. (1)

(1.) Shannon C, Brothers LP, Philip NM, et al. Infection after medical abortion: a review of the literature. Contraception 2004;70:183-90.
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Title Annotation:ROUND UP: Medical Abortion
Publication:Reproductive Health Matters
Date:Nov 1, 2005
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