Preoperative vaginal cleansing with povidone-Iodine and its effect on post cesarean section infectious morbidity

Abstract EN

Background : Post-operative infection remains a significant complication of caesarean delivery, rates of post-caesarean infections range from 7-20 % which can lead to health morbidities and economic burden Aim : To assess the effect of preoperative vaginal cleansing using povidone-iodine 10 % solution on rates of post cesarean section infectious morbidities ( Endometritis, maternal fever and wound infection).

Subjects and Methods : This prospective randomized controlled study has been conducted among 218 pregnant women scheduled for term elective CS.

They were equally randomized into intervention and control groups.

Intervention group received preoperative vaginal cleansing using 10 % povidone iodine while control group did not receive vaginal cleansing.

All cases received prophylactic antibiotics and the usual abdominal scrub.

Adverse post caesarean infectious morbidities were observed as endometritis, fever, and wound infection at time of hospital discharge and weekly for one month in post partum period.

Results : Both groups were matched as regarding baseline patients' characteristics (age, gestational age, body mass index (BMI), operative time, and Post-operative hospital stay) ; overall post CS infectious morbidity was significantly reduced from 25.5 % in the control group to be 8.8 % in the intervention group.

Marked reduction was seen in the incidence of endometritis (14.3 % in the control group versus 2.9 % in the intervention group ; p-value < 0.05).

However, fever and wound infection showed no significant difference between both groups.

Conclusion : Preoperative vaginal cleansing with povidone iodine prior to CS is effective in reducing incidence of post CS infectious endometritis with no effect on wound infection or fever.