Morbidity that is associated with curettage for the management of spontaneous and induced abortion in women who are infected with HIV.
OBJECTIVE
The purpose of this study was to determine the morbidity that is associated with curettage for the management of abortions in women who were infected with human immunodeficiency virus compared with women who were not infected with human immunodeficiency virus.


METHODS
Women who were infected with human immunodeficiency virus (cases) and who underwent curettage for the management of scheduled and unscheduled abortions in the first half of pregnancy between January 1, 1993, and December 31, 2002, were identified. Women who were not infected with human immunodeficiency virus (control subjects) were matched 3:1 to cases for gestational age, type of abortion, and year of procedure. Medical records were reviewed to obtain demographic characteristics, gestational age, abortion characteristics, and procedure-related complications. Chi-squared test, Student t test, and Wilcoxon rank-sum test were used to determine statistical significance.


RESULTS
Seventy-one women who were infected with human immunodeficiency virus (cases) and 213 women who were not infected with human immunodeficiency virus (control subjects) who underwent curettage during the study period were evaluated. Forty-eight cases (68%) and 146 control subjects (69%) underwent a scheduled curettage. Twenty-three cases (32%) and 66 control subjects (31%) underwent an unscheduled curettage for spontaneous or incomplete abortion. No significant differences were seen in age, gravidity, or parity. There were significantly more black women in the HIV-infected cohort (P < .001), which was representative of our human immunodeficiency virus population. The mean gestational age in the cases was greater than in the control subjects (10.9 +/- 4.2 weeks of gestation vs 9.2 +/- 3.1 weeks of gestation; P = .004). Procedure-related complications occurred in 10 of the women (14%) who were infected with human immunodeficiency virus who underwent curettage, compared with 9 of the women (4%) who were not infected with human immunodeficiency virus (P = .004). With the use of logistic regression, complication rates were unaffected by the difference in gestational age. Infectious complications did not differ between the 2 groups (P = .435).


CONCLUSIONS
There was a higher rate of procedure-related complications among women who were infected with human immunodeficiency virus and who underwent curettage for management of spontaneous and induced abortions. There was no increase in infectious morbidity in the women who were infected with human immunodeficiency virus.
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Tex 75390-9032, USA. gretchen.stuart@utsouthwestern.edu
Gretchen S
GS
Stuart
Jeanne S
JS
Sheffield
James B
JB
Hill
Donald D
DD
McIntire
Barbara
B
McElwee
George D
GD
Wendel
D000028:Abortion, Induced / Q000379:methods*; D000022:Abortion, Spontaneous / Q000601:surgery*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003475:Curettage / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy