Mid-trimester amniocentesis and antibiotic prophylaxis.
OBJECTIVE
Assuming that the rate of fetal loss after amniocentesis may be reduced in patients receiving antibiotic prophylaxis, we conducted a retrospective study on untreated versus treated patients receiving prophylactic antibiotics (amoxicillin/clavulanic-acid or azithromycin) and evaluated the fetal loss rate within the 22nd week of gestation, also with respect to the risk of spontaneous abortion, both preexisting and related to mid-trimester amniocentesis.


RESULTS
Spontaneous abortion occurred in 22 cases out of 1744 (1.26%). The incidence of spontaneous abortion was 1.3% among patients treated with antibiotic prophylaxis and 1.2% among untreated patients. Between patients with risk factors that predated amniocentesis, the spontaneous fetal loss rate was 9.2% in untreated patients versus 2.3% in patients treated (p = 0.10). In patients with procedure-related risk factors at amniocentesis, the spontaneous abortion rate was, respectively, 2.2 and 1.2% (p = 0.72).


CONCLUSIONS
Our data demonstrate that antibiotic prophylaxis does not reduce the risk of spontaneous abortion within the 22nd week of gestation. Compared with untreated patients, patients treated with amoxicillin showed the lower fetal loss rate (1.16 vs 0.31%), but the difference was not statistically significant (odds ratio (OR) = 3.68, p = 0.32). The same was true for patients with preexisting risks (OR = 4.25, p = 0.10).
Gramellini
Dandolo
D
Department of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. dandolo.gramellini@unipr.it
Fieni
Stefania
S
Casilla
Giovanna
G
Raboni
Stefano
S
Nardelli
Giovanni Battista
GB
D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000008:administration & dosage; D019818:Clavulanic Acid / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin; D017963:Azithromycin