title: Mid-trimester amniocentesis and antibiotic prophylaxis.
abstract: 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).
authors.affiliation: Department of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. dandolo.gramellini@unipr.it
authors.forename: Dandolo
authors.initials: D
authors.lastname: Gramellini
authors.forename: Stefania
authors.initials: S
authors.lastname: Fieni
authors.forename: Giovanna
authors.initials: G
authors.lastname: Casilla
authors.forename: Stefano
authors.initials: S
authors.lastname: Raboni
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Nardelli
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin; D017963:Azithromycin