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Fever and Bacteremia Associated with Hypertonic Saline Abortion

From the Departments of Medicine and Obstetrics and Gynecology, The New York Hospital, Cornell University Medical Center, 525 East 68th St, New York, NY 10021.

Abstract

A study was undertaken to define the incidence of fever and bacteremia in patients undergoing hypertonic saline abortion. The records of 302 patients were reviewed. The incidence of febrile complications was found to be 18.5%. Fever occurred either during the time of labor or closely following the expulsion of the products of conception. Six of 56 febrile patients had positive blood cultures, while potential pathogens were isolated from the reproductive tract of 15 others. A prospective study with serial blood cultures was conducted on 43 patients to determine the frequency of transient bacteremia following the intra-amniotic instillation of saline. Although an incidence of fever similar to that in the retrospective group were encountered, there were no positive blood cultures. A febrile episode may occur in approximately 20% of cases, but in many of these, bacterial infection cannot be demonstrated. It is concluded that the prophylactic use of antibiotics is not warranted.