***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a single-blind r and omized study , the efficacy of a single intravenous dose of sulbactam ( 0.5 g ) plus ampicillin ( 1 g ) was compared with that of placebo in the prophylaxis of  early postoperative endometritis after abortion with vacuum aspiration in the first trimester . Administration of either sulbactam/ampicillin or placebo occurred immediately before the operation . The two treatment groups were equally matched with respect to patient 's age , gestational age , presence of an intrauterine device , and baseline bacteriologic findings . During the first seven postoperative days , four of 145 patients who had received sulbactam/ampicillin  and 11 of 140 patients who had received placebo  were diagnosed as having endometritis . No adverse effects and no laboratory test abnormalities attributable to treatment were reported in either group . A single dose of sulbactam/ampicillin reduced the incidence of early postoperative endometritis after abortion with vacuum aspiration in the first trimester A clinical , controlled trial was performed to study the effect of prophylaxis with lymecycline and the role of Chlamydia trachomatis and Mycoplasma hominis in postabortal genital infection . Of 532 women who were to undergo first-trimester abortion , 269 were r and omized to treatment with oral lymecycline ( 300 mg bid ) starting 2 days before the abortion and continuing for a total of 7 days , and 263 were r and omized to placebo treatment . The rate of postabortal infection was 9.3 % in the antibiotic group and 9.5 % in the placebo group , an insignificant difference ( P greater than .8 ) . The presence of C. trachomatis in the cervix/urethra at the time of abortion showed a significant association with the occurrence of postabortal infection ( P less than .005 ) , but there was no correlation between the effect of treatment and the presence of infection ( P greater than .4 ) . The presence of M. hominis , a history of pelvic inflammatory disease , maternal age , gestational age , the number of births , spontaneous and induced abortion , and the Hegar number showed no significant association with postabortal infection ( all P values greater than .05 ) . It is recommended that women who are to undergo induced abortion be examined for the presence of C. trachomatis and treated , as they constitute a risk group PURPOSE Clinical innovations have made it more feasible to incorporate early abortion into family medicine , yet the outcomes of early abortion procedures in this setting have not been well studied . We wished to assess the outcomes of first-trimester medication and aspiration abortion procedures by family physicians . METHODS Prospect i ve observational cohort study conducted from August 2001 to February 2005 of 2,550 women who sought pregnancy termination in 4 clinical practice s of family medicine departments and 1 private office/training site . RESULTS The rate of successful uncomplicated procedures for medication was 96.5 % ( 95 % confidence interval [ CI ] , 95.5%–97.0 % ) and for aspiration was 99.9 % ( CI , 99.3%–1 ) . Adverse events and complications of medication abortions were failed procedure ( ongoing pregnancy ; n = 19 , 1.45 % ) ; incomplete abortion ( n = 16 , 1.22 % ) ; hemorrhage ( n = 9 , 0.69 % ) ; and patient request for aspiration ( n = 1 , 0.08 % ) . One ( 0.08 % ) missed ectopic pregnancy was seen among patients receiving medication . Four types of adverse outcomes were encountered with aspiration : incomplete abortion requiring re-aspiration ( n = 21 , 1.83 % ) ; hemorrhage during the procedure ( n = 4 , 0.35 % ) ; missed ectopic pregnancy ( n = 3 , 0.26 % ) ; and minor endometritis ( n = 1 , 0.09 % ) . Missed ectopic pregnancies were successfully treated in the inpatient setting without mortality ( overall hospitalization rate of 0.16 of 100 ) . All other complications were managed within outpatient family medicine sites . Rates of complication did not vary by experience of physician or by site of care ( residency vs private practice ) . CONCLUSIONS Complications of medication and aspiration procedures occurred at a low rate , and most were minor and managed without incident the risks of morbidity and mortality affect a teenager 's choice between termination of a pregnancy through induced abortion and continuation of the pregnancy . To identify these risks , we analyzed information from two separate sets of data collected by the Centers for Disease Control : that of the Joint Program for the Study of Abortion , a multicenter prospect i ve study of nearly 165,000 legally induced abortions ; and that of a national surveillance of abortion-related mortality . The rates of major complications associated with abortions in teenagers were 1 to 3 per 1000 suction-curettage procedures and approximately 13 per 1000 saline-administration procedures . The death-to-case rate for teenage women was 1.3 per 100,000 procedures . When the data on procedures were adjusted according to gestational age , teenagers generally had lower rates of morbidity and mortality from induced abortion than older women The objective of this study was to determine whether propofol and methohexital differ in their efficacy , acceptability , cost and side effects when used as the single anesthetic agent for inducing general anesthesia in first-trimester vacuum abortion . We r and omized 400 unpremedicated American Society of Anesthesiologists grade I-II women to receive 1 % propofol or 1 % methohexital  by intravenous bolus infusion during abortion . No ancillary anesthetic or adjunctive drugs were used . Visual analogue scale scores were used to grade preoperative patient anxiety and the quality of the anesthetic experience . All personnel outside the operating suites , except the data analyst , were blinded . Chi2 , median , analysis of variance and Student 's t-tests were used , as appropriate . There were no statistically significant differences in age , gravidity , parity , spontaneous and induced abortion , body mass index or gestational age . Mean total operating time and total drug dose were similar . Propofol use result ed in a significant reduction in the incidence of postoperative nausea ( 11.5 % vs. 17.5 % ) or vomiting ( 3.5 % vs. 7.0 % ) with a combined p ( mean difference ) = 0.002 ( 95 % confidence interval of the mean difference 1.8 % , 17.2 % ) . Both the nursing and patient appraisal s of the quality of the anesthetic experience favored propofol , but only the nursing scores reached statistical significance ( p < 0.001 ) . The cost differential was more than twofold greater for propofol patients , 9.51 dollars vs. 4.42 dollars . In our population of midwestern patients in a major urban area , propofol use had modest advantages over methohexital when used as single agents as judged by first recovery charge nurses , but patients found them equally acceptable OBJECTIVES We compared complication rates after  surgical abortions performed by physician assistants  with rates after abortions performed by physicians . METHODS A 2-year prospect i ve cohort study of women undergoing surgically induced abortion was conducted . Ninety-one percent of eligible women ( 1363 ) were enrolled . RESULTS Total complication rates were 22.0 per 1000 procedures ( 95 % confidence interval [ CI ] = 11.9 , 39.2 ) performed by physician assistants and 23.3 per 1000 procedures ( 95 % CI = 14.5 , 36.8 ) performed by physicians ( P = .88 ) . The most common complication that occurred during physician assistant-performed procedures was incomplete abortion ; during physician-performed procedures the most common complication was infection not requiring hospitalization . A history of pelvic inflammatory disease was associated with an increased risk of total complications ( odds ratio = 2.1 ; 95 % CI = 1.1 , 4.1 ) . CONCLUSIONS Surgical abortion services provided by experienced physician assistants were comparable in safety and efficacy to those provided by physicians In a prospect i ve study , 519 women were r and omly selected for cervical dilatation  by laminaria tents or Hegar dilators before scheduled vacuum aspiration . In other 68 women r and omly divided into a laminaria group and a control ( Hegar ) group , placenta , decidua and blood were separately aspirated from the uterine cavity before the vacuum aspiration and cultured for micro‐organisms . The rate of postabortal pelvic inflammatory disease ( PID ) was significantly lower after pretreatment with laminaria tent irrespective of patient 's age and parity . However , a higher risk of postabortal PID was found in gestational age of 10–12 weeks than of 5–9 weeks . Previous PID and abortion did not increase the risk of postabortal PID . Vaginalkervical micro‐organisms were , irrespective of method for cervical dilatation , identified in two thirds of the patients A prospect i ve , nonconcurrent cohort analysis of 178 mifepristone/misoprostol and 199 suction curettage abortion subjects , ages > or = 18 years , with intrauterine pregnancies < or = 63 days estimated gestational age , was conducted to compare the outcomes of suction curettage abortion to those of medical abortion . The medical abortion subjects received 600 mg of mifeprisone orally , followed by 400 micrograms of oral misoprostol 2 days later . Surgical abortion subjects underwent electronic vacuum aspiration . All subjects were followed for 2 weeks or until the absence of clinical bleeding . Outcome measures included a successful abortion ( complete abortion without a surgical intervention ) , duration of bleeding , and morbidity . Overall , 18.3 % medical and 4.7 % surgical patients failed their primary procedure and received an unanticipated suction curettage ( RR 3.93 , 95 % CI 1.87 , 8.29 ) . Four mifepristone subjects required curettage for acute bleeding , nine to manage ongoing pregnancy , and five for incomplete abortion .  Fourteen mifepristone and eight surgical subjects required curettage for persistent bleeding . The median time delay for therapeutic curettage was significantly longer in the medical abortion group ( 35 versus 8 days ; Mann-Whitney U = 17.0 , p = 0.008 ) . Medical subjects experienced significantly longer bleeding ( mean difference = 9.6 days , 95 % CI 6.8 , 12.4 ) . No significant change in hemoglobin occurred in either group . Mifepristone patients reported significantly greater pain ( 77.1 % vs 10.5 % ; RR 7.4 , 95 % CI 4.7 , 11.5 ) , and nausea or vomiting ( 68.6 % vs 0.6 % ; RR 117.9 , 95 % CI 16.7 , 834.7 ) . Women receiving mifepristone/misoprostol are more likely to require an unplanned surgical intervention than women who undergo suction curettage . They experience more discomfort with their procedure and in the follow-up interval , bleed for a longer period , and remain at risk for surgical completion curettage for several weeks OBJECTIVE To assess the incidence of complications of abortion performed under local anesthesia .  DESIGN Prospect i ve study . SETTING A family planning center in the Paris area . POPULATION Eight hundred and fifty-eight women admitted for abortion under local anesthesia .  MAIN OUTCOME MEASURES Incidence of immediate ( the day of vacuum aspiration ) and delayed complications ( at the follow-up visit 2 weeks after the procedure ) . RESULTS Among the 858 women who underwent vacuum aspiration , 683 ( 80 % ) attended the follow-up visit 2 weeks after the procedure . Fifty-nine percent of the 858 women had not had a previous abortion , 25 % had had one , and 16 % had had two or more . The average duration of amenorrhea was 8.6 weeks ( 19 % at 6 or 7 weeks , 67 % between 8 and 10 weeks , and 14 % after 10 weeks ) . The overall complication rate was 3.4 % ( 23/683 ) ( 95 % CI=2.0 - 4.8 % ) . The incidence of immediate complications was 1.7 % ( 15/858 ) ( 0.8 - 2.6 % ) and that of delayed complications 1.2 % ( 8/683 ) ( 0.4 - 2.0 % ) . CONCLUSION This study confirms the safety and efficacy of abortion by vacuum aspiration under local anesthesia BACKGROUND Since 1991 , mifepristone in combination with a prostagl and in analogue has been licensed for termination of pregnancy in the UK at up to 9 weeks amenorrhoea , and since 1995 , beyond 13 weeks . Surgical methods are used almost exclusively at 10 - 13 weeks amenorrhoea . METHODS A patient-centred , partially r and omized , controlled trial was carried out . Those who expressed a strong preference for either medical ( n = 15 ) or surgical ( n = 62 ) abortion were allocated 
    Output:
    
The percentage of first-trimester aspiration abortions that required interventions for minor and major complications was very low .
Overall , the prevalence of major complications was similar across clinic context s , indicating that this procedure can be safely performed in an office setting .
IMPLICATION S Laws requiring abortion providers to have hospital admitting privileges or facilities to meet ambulatory surgical center st and ards would be unlikely to improve the safety of first-trimester aspiration abortion in office setting