Vaginal Preparation with Antiseptic Solution (Povidone iodine 10%) before Cesarean Section for Preventing Postpartum Infections: A Prospective Observative Cohort Study

Abstract

Cesarean section is one of the most frequently performed surgical procedures by the obstetricians. After 13 years of consecutive increases, the total U.S cesarean delivery rate reached a high of 32.9% of all birth in 2009. The total cesarean delivery rate declined in 2010 to 32.8% and was stable for 2011 and 2012. Objective: To determine the role of preoperative vaginal preparation with povidone iodine to reduce post cesarean infectious morbidities. Methods: We conducted this prospective observative cohort study to asses the effect of vaginal preparation with antiseptic solution before cesarean section in reducing postpartum infections on pregnant women undergo caesarean section (emergency and elective) divided into two groups: Group A received vaginal preparation with antiseptic solution povidone-iodine before cesarean section and Group B not receive vaginal preparation before cesarean section. Primary outcome was Post-partum infection (endometritis and wound complications). And Secondary outcomes were Post-partum fever & Side effects of vaginal preparation (allergy, irritation). Results: In our study, there were 1000 cases divided into two groups, 227 patients included in group (A) which vaginaly prepared by povidine iodine 10% of them (6 patients) developed endometritis, 13 patients developed wound infection, and 19 patients developed postoperative fever, 773 patients included in group (B) which not vaginally prepared of them 63 patients developed endometritis, 88 patients developed wound infection, and 115 patients developed postoperative fever. Conclusion: Vaginal cleansing is a safe, rapid, cheap and well tolerated intervention, and should be used as an adjunct to prophylactic antibiotics immediately before caesarean section to reduce the bacterial exposure of the endometrium and other maternal tissues during caesarean section.