Maastricht, 15-16 octobre 1999: „Third FIAPAC-Konferenz“
16:00Antibiothérapie et avortementPrésident:
- Pierre Moonens, BE
- Paul Cesbron, FR (all speeches)
In France from 1990 to 1995 1,000,000 legal abortions were carried out. There
were 4 deaths linked without certitude to an infection, 1 0/00 peritonitus and
about 1% of minor complications with up to 12 weeks of amenorrhia There are
few long term post-infection effects.
Women with a history of pelvic infection run a real risk of infectious complications.
The speaker quotes an American study:
1/1400 abortion leads to hospitalisation.
1/4500 leads to a serious infection.
What antibiotic therapy: 1 dose of DOXYCYCLINE 200mg 2 hours before, 200mg
12 hours after.
At the moment the incidence of infection is not known.
The majority of centres do not practise a systematic antibiotic therapy.
The discussion underlined the different medical practices. In Spain
DOXYCYCLINE is systematically used for 5 days, in Germany there is screening
for Chlamydia with treatment in positive cases.
The specific case of Russia where women under go a high number of abortions
shows a linked rise in the incidence of Chlamydia.
In conclusion: although this is a quantifiable field consensus is not possible
- A. Talens, NL (all speeches)
Chlamydia: 5 to 20%
Gonorrhoea: 0.2 to 3%
Current practices: Prophylaxy if the woman is under 30 years of age
DOXYCYCLINE 300mg the day before and then 100mg/ day for 2 days or 200mg
for 7 days.
Prescription of METRODINAZOL over 18weeks amenorrhia taking into account
that the risk increases with the length of pregnancy. The conclusion of the Dutch
practice is that all women asking for abortions must be treated.
- Elisabeth Aubény, FR (all speeches)
- Christian Fiala, AT (all speeches)
- firstname.lastname@example.org ,http://www.gynmed.at
Austria: only in hospitals
Germany: not available under study
Holland: judged not useful
Spain: price not yet defined
Switzerland: RU486 = poison so forbidden
Reminder of the law. 75% of cost paid back.
A week to think over before taking MIFEPRISTONE as well as a psycho-social
counselling session. Ultrasound between D10 D14 if there is a doubt. Result: 98.5% success rate. Continued pregnancy 1 0/00.
Doctors are badly paid.
Abortions are carried out by doctors in their private surgeries with out time given
to think it over. The Church puts pressure on the public hospital system.
40 000 abortions per year.
Only one public hospital prescribes MIFEPRISTONE.
Consultations take place by phone. There is a lack of information.
Success rate of 97%.
Choice of method:
The method is perceived as being less aggressive, "natural.
It represents 14% of the legal abortions in 1990 and 30 to 40% in 1998.
The choice is made in relation to how early in pregnancy the request is made.
A non-surgical method with the possibility of the partner being present.
The question as to whether the method should be available up to the 63rd day is
The discussion showed the advantages that would arise from "de-medicalising
this method and using it at home (defended by A. BUREAU France) up to the
49th day of amenorrhe.
It was accepted that studies must be carried out to reduce the dose of
MIFEPRISTONE to 200mg and to look into different protocol.
This third seminar ended after a series of rich and formative exchanges on the
practices of the different participants.
A change in the statutes was decided by the founder members. From now on the
F.I.A.P.A.C. , for democratic and voting reasons, is no longer an association of
associations but an association of individual members. The membership fee for
2000 is 250 F.
It was decided to meet again in Paris for the 4th seminar on 24th and 25th
- Dominique Roynet, BE (all speeches)
98% of abortions are carried out in non-hospital situations with very few medical
staff. The antibiotics prescribed are chosen in relation to the age, the sexual
precociousness and the number of partners.
The talk underlined the frequency of asymptomatic carriers , the increase in the
occurrence of Chlamydia 3%. Gonorrhoea tending to disappear.
The criteria for screening are thus defined:
&Mac183; More than 2 partners per year
&Mac183; Request for abortion
&Mac183; Before putting in an I.U.D.
&Mac183; Partner infected with a S.T.D.
&Mac183; The pill before 18
&Mac183; Abdominal pains
&Mac183; Screening for S.T.D.
Treatment : 200mg DOXYCYCLINE for 2 days.
Abortion postponed for a week in the case of Chlamydia