title: Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial.
abstract: OBJECTIVE
  To compare procedure-related pregnancy loss after second-trimester genetic amniocentesis in women given an antibiotic prophylaxis and controls.
  
  
  METHODS
  Prospective, open randomised controlled single-centre study between January 1999 and December 2005 at Artemisia Fetal Maternal Medical Centre. A follow-up within 4 weeks after the procedure was done.Of 36,347 eligible women, 1424 refused to participate and 34,923 were enrolled and randomised with unequal chance of selection, 21,991 were assigned to treatment group and 12,932 were assigned to the control group, and did not receive any placebo. Oral azithromycin, 500 mg per day, was administered 3 days before amniocentesis. The primary endpoint was the procedure-related pregnancy loss. The secondary endpoint was the rate of preterm premature rupture of membranes.
  
  
  RESULTS
  The rate of abortion related to the amniocentesis was 7/21 219 women (0.03%, 95% CI 0.009-0.057) in the intervention group, and 36/12 529 (0.28%, 0.28-0.30) in controls (p = 0.0019). The rate of preterm premature rupture of membranes was 14/21 219 (0.06%, 0.031-0.101) in the intervention group, and 140/12 529 (1.12%, 0.94-1.30) in the control group (p = 0.001).
  
  
  CONCLUSIONS
  Antibiotic prophylaxis before second-trimester amniocentesis reduced the risk of abortion and of rupture of the membranes.
authors.affiliation: Department of Prenatal Diagnosis, Artemisia Fetal-Maternal Medical Centre, Rome, Italy. claudio.giorlandino@artemisia.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Giorlandino
authors.forename: Pietro
authors.initials: P
authors.lastname: Cignini
authors.forename: Marco
authors.initials: M
authors.lastname: Cini
authors.forename: Cristiana
authors.initials: C
authors.lastname: Brizzi
authors.forename: Ornella
authors.initials: O
authors.lastname: Carcioppolo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Milite
authors.forename: Claudio
authors.initials: C
authors.lastname: Coco
authors.forename: Paolo
authors.initials: P
authors.lastname: Gentili
authors.forename: Lucia
authors.initials: L
authors.lastname: Mangiafico
authors.forename: Alvaro
authors.initials: A
authors.lastname: Mesoraca
authors.forename: Domenico
authors.initials: D
authors.lastname: Bizzoco
authors.forename: Ivan
authors.initials: I
authors.lastname: Gabrielli
authors.forename: Luisa
authors.initials: L
authors.lastname: Mobili
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000627:therapeutic use*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
chemical_list: D017963:Azithromycin