A RANDOMIZED TRIAL OF PROPHYLACTIC DOXYCYCLINE FOR CURETTAGE IN INCOMPLETE ABORTION

Objective: To determine whether prophylactic doxycycline at suction cu rettage for incomplete abortion decreases the rate of postoperative pe lvic infection. Methods: We randomized 240 patients to receive intrave nous doxycycline or placebo at curettage. Cervical specimens for gonor rhea and chlamydia were obtained preoperatively. Two weeks post-proced ure, we evaluated all patients for infectious morbidity and repeated g onorrhea and chlamydia cultures. Statistical analysis used Mann-Whitne y U test, McNemar test, or Fisher exact test, as appropriate. Results: There were no statistically significant differences in age, parity, g estational age, history of sexually transmitted disease, pelvic inflam matory disease, or multiple sex partners between the doxycycline and p lacebo groups. Preoperative gonorrhea or chlamydia isolates were posit ive in five (4.2%) and six (5%) of 120 doxycycline patients and four ( 3.3%) and eight (6.6%) of 120 controls (not significant). All preopera tive gonorrhea isolates remained positive postoperatively. Seven (5.8% ) controls had positive postoperative chlamydia isolates, as did one ( 0.8%) in the doxycycline group (P = .06). We diagnosed eight (6.6%) of 120 doxycycline patients and seven (5.8%) of 120 controls with infect ious morbidity (not significant). Conclusion: In our population of pat ients with incomplete abortion, the prevalence of gonorrhea and chlamy dia was low, and prophylactic doxycycline did not decrease the rate of postoperative febrile morbidity.