title: Is preoperative vaginal cleansing necessary for control of infection after first trimester vacuum curettage?
abstract: BACKGROUND
  Traditionally, the vagina is cleansed, before a curettage is performed. A previous study, comparing cleansing with chlorhexidine solution and cleansing with saline solution before vacuum aspiration in the first trimester, did not show any difference in the frequency of postoperative pelvic inflammatory disease. We wanted to investigate whether this was true also for vaginal cleansing with chlorhexidine, compared to no vaginal cleansing at all.
  
  
  METHODS
  Consecutive women having surgical first trimester legal abortions were randomized to vulvar and vaginal cleansing with chlorhexidine or vulvar cleansing only. The frequency of postabortion pelvic inflammatory disease was evaluated with patient questionnaires and study of medical records.
  
  
  RESULTS
  Of the 486 patients included in the study, vaginal cleansing was performed on 246 and no vaginal cleansing on 240. The frequency of probable pelvic inflammatory disease was 2.4% with cleansing and 2.1% without cleansing (no significant difference).
  
  
  CONCLUSIONS
  Under certain conditions, preoperative vaginal cleansing can be safely omitted.
authors.affiliation: Department of Obstetrics and Gynecology, Southern Hospital, Stockholm, Sweden.
authors.forename: Ingela Hulthén
authors.initials: IH
authors.lastname: Varli
authors.forename: Anna
authors.initials: A
authors.lastname: Lindelius
authors.forename: Mats
authors.initials: M
authors.lastname: Bergström
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016015:Logistic Models; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000009:adverse effects*; D014621:Vagina
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine