Implementation of vaginal preparation prior to caesarean section (original) (raw)
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Vaginal Cleansing Prior to Cesarean Section and Post-Operative Infectious Morbidity
2018
Objective: To compare the frequency of post-operative infectious morbidity in patients undergoing emergency cesarean section with and without pre-operative vaginal cleansing.Methodology: A Randomized controlled trial in the department of obstetrics and gynecology, PIMS, Islamabad from 1st September 2014 to 31st January 2015 was conducted including 434 patients. Group B women received only abdominal and vulval scrubbing while Group A received additional vaginal cleansing with pyodine. Patients were followed up for development of infectious morbidity up to three weeks. Results: Mean age of 28.4 ± 4.6 years in group A and 27.6 ± 5.9 years in group B. Fever was seen in 9 (4.1%) women in group A and 16 (7.4%) in group B (p=0.149). Endometritis was noted in 3 (1.4%) women in group A and 19 (8.8%) in group B (p=0.000). Wound Infection occurred in 3 (1.4%) women in group A and 8 (3.7%) in group B (p=0.126).Conclusion: Use of antiseptic for vaginal cleaning before cesarean section decreased ...
PARIPEX INDIAN JOURNAL OF RESEARCH, 2021
Introduction: Caesarean section (CS) is one of the commonest surgical procedures performed in obstetrics. Postoperative infectious complications including surgical site infections (SSI) are a cause of significant morbidity after CS as compared to vaginal delivery. Aim: To assess the role of application of surgical bundle and vaginal cleaning before caesarean section in preventing postoperative infectious complications. Design: Prospective randomised interventional study. Place and duration of study: Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and hospital,Aligarh from November 2016 to October 2018. Methodology: Total of 216 patients undergoing emergency CS in the hospital was enrolled in the study. Patients were kept in 2 groups. In group 1, women undergoing emergency C-Section whom conventional preoperative preparation was done using savlon-povidone iodine as skin antiseptic and a 7 day postop prophylactic antibiotic regime was administered.In group 2...
Effect of Preoperative Vaginal Cleansing to Reduce Post Caesarean Infection
2020
preoperative vaginal wash with povidone iodine reduced the vaginal bacteria up to 98% which can in turn reduce ascending bacteria from the vagina to the uterus end reduce post cesarean infection . The purpose of the study was to assess effect of preoperative vaginal cleansing to reduce post caesarean infection. Methods: A quasi-experimental design was utilized. Sample: A convenience sample of 162 pregnant women in the full term pregnancy. Setting: The study was carried out at Menoufia University Hospital at Shebin El-Kom and Menouf General Hospital at menouf. Instruments: An interviewing questionnaire, maternal assessment tool, cesarean examination tool, follow up assessment tool. Results: There was a statistically significant reduction in postoperative infection in the study group compared to the control group. Conclusion: preoperative vaginal cleansing with povidion iodine is effective in the reduction of post cesarean infection. Recommendations: Preoperative vaginal preparation w...
Acta Obstetricia et Gynecologica Scandinavica
Introduction: Infection is one of the most common causes of maternal morbidities and mortality and has been reported to be responsible for about 15% of maternal deaths. Any woman is at risk of infection during childbirth, but women undergoing cesarean section are at higher risk. Improvement in surgical procedures with asepsis and the use of antibiotics have helped reduce postoperative infectious morbidities. However, ascending infection from the lower to the upper genital tract is a common but often neglected source of infection. Cleaning the vagina with chlorhexidine antiseptic solution before cesarean section can be a cheap and affordable source of infection control. This study is aimed at evaluating the efficacy of preoperative vaginal cleansing using 1.0% chlorhexidine in the reduction of post-cesarean section infectious morbidities. Material and methods: This prospective randomized control trial was conducted among 322 pregnant women who underwent an emergency cesarean section at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FUTHA). The women were randomized into two groups. The interventional group received vaginal cleansing with three standard gauzes soaked in 30 mL 1.0% chlorhexidine gluconate solution preoperatively in addition to surgical skin cleaning with chlorhexidine-alcohol. The women in the control group only had surgical skin cleaning with chlorhexidinealcohol. All the women received pre-and postoperative antibiotics. The primary outcomes were endometritis and wound infections. Results: Infectious morbidity was significantly reduced from 36.8% in the control group to 12.0% in the intervention group (P = .001). Endometritis occurred significantly less frequently in the intervention group than the control group (respectively 6.6% compared with 27.6%: relative risk [RR] 0.29, 95% confidence interval [CI] 0.16-0.53; P < .05). Foul-smelling vaginal discharge was significantly more common in the control group than in the intervention group (11.8% vs 1.3%, respectively) but the | 695 OGAH et Al.
International Journal of Medical Arts, 2022
Article information Background: Cesarean delivery is the commonest surgical procedure practiced by Obstetricians and its incidence continues to rise. It is associated with significant morbidity, and infection is one of the most common postoperative complications. Different interventions are described to decrease the rate of infection. The use of vaginal antiseptics and antimicrobial was prescribed. However, the results are inconsistent. The aim of the work: The current work aimed to determine the value of pre-surgical vaginal cleaning by a 5% chlorhexidine gluconate solution could reduce the risk of maternal infections after cesarean delivery. Patients and Methods: This study included 400 women attending obstetrics and gynecology departments to deliver by elective cesarean section. The study had been completed between the beginning of January 2019 to the end of December 2021. All women were randomized to one of two equal groups. The first included 200 women where no wash was done [Control group]. The second included another 200 cases where wash with chlorhexidine gluconate was done [Study group]. At the time of hospital discharge and again at one month post delivery. The rate of endometritis and different wound complications were documented and compared between groups. Results: The control and study groups were comparable regarding female age, parity, gestational age at delivery, primary cesarean section, operative time. However, postoperative hospital stay duration was significantly longer in control than the study group [43.26±10.62 vs. 39.69±9.21 hours, respectively]. Hemoglobin concentrations revealed non-significant difference between the study and the control groups before and after cesarean delivery. However, it was significantly reduced in both groups after surgery than values before surgery. Endometritis was reported among 12.5% of the control group, compared to 7.0% of the study group, with no significant difference between the study and the control groups. However, the overall wound complications were significantly increased among control than study group and composite complications were also significantly increased in control than the study group [12.0% vs 4.0% respectively]. Lower preoperative hemoglobin was the only significant associated factor for development of endometritis. Conclusion: Peroperative vaginal preparation with 5.0% chlorhexidine gluconate solution is associated with a reduction in post-cesarean infectious complications [mainly endometritis] wound infection and other wound-related complications. It is recommended to be a routine practice before cesarean delivery.
Abstract Objective: To evaluate the efficacy of preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes on rates of postcesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection). Methods: This prospective randomized trial was conducted among 218 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization. After spinal anesthesia and catheterization under aseptic technique, the study group had preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes for about 1 min, while the control group did not. All cases received the prophylactic antibiotics and the usual abdominal scrub. All participants received the routine postoperative care without other interventions. Adverse postcesarean infectious morbidities such as endometritis, febrile morbidity and wound infection were observed at the time of hospital discharge and weekly for 6 weeks postpartum. Results: Both groups were matched regarding the baseline patients’ characteristics (age, gestational age, BMI, operative time and postoperative hospital stay). Overall, post-CS infectious morbidity were significantly reduced from 24.4% in the control group to 8.8% in the intervention group; p value50.05. Marked reduction was seen in the incidence of endometritis (13.2% in the control group versus 2.9% in the intervention group; p value50.05). However, fever and wound infection showed no significant difference between both groups. Conclusion: Cleansing the birth canal with chlorhexidine 0.25% wipes prior to elective CS appears to be effective in reducing rates of post
International journal of scientific research, 2020
Objective: To evaluate the efficacy of pre-cesarean vaginal wash using 5% Povidone Iodine solution on rate of post-cesarean section (CS) surgical site infection and compared with No swabbing. Method: A Prospective Randomized controlled Trial was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. In interventional group, vaginal swabbing with a gauze pieces impregnated with 5% Povidone Iodine solution was done for 30 seconds. The swabbing of vagina was not performed in cases assigned to control group, however the standard surgical preparation of abdomen was done in a usual manner for both group. All subject received prophylactic antibiotic cover. Collected data was complied in pre-designed proforma and analysis was done using SPSS 15. Result: The risk of post operative fever and wound infection was significantly reduced in interventional group. No measure difference was noted in seroma and composite wound infection. Also less duration of h...
Clinical Nursing Studies
Objective: This study aims to assess effect of preoperative vaginal cleansing using chlorhexidine antiseptic on post cesarean section infectious morbidity.Methods: A randomized controlled trial was conducted on a random sample of 178 singleton term pregnant woman assigned for elective cesarean section. A simple random sample was recruited from the operating room of Obstetrics and Gynecology department, Zagazig University Hospitals-Egypt. Participants were randomly assigned either to conventional care group or study group. The conventional care group was exposed to the usual abdominal scrub with Povidone-iodine solution; while the study group subjected to vaginal cleansing using chlorhexidine antiseptic solution in addition to conventional preoperative care. Data were collected using an assessment sheet for demographic and clinical data and checklist for study outcomes.Results: Post intervention, assessment of the incisional wound revealed lower overall post cesarean section infectio...
American Journal of Obstetrics & Gynecology MFM, 2019
BACKGROUND: Several randomized controlled trials have demonstrated that preoperative abdominal skin preparation with chlorhexidine gluconate is superior to povidone-iodine for the prevention of surgical site infections. Despite these results, povidone-iodine is still the most commonly used agent for vaginal preparation, even though it may not be ideal. OBJECTIVES: The objectives of the study were as follows: (1) to determine whether vaginal cleansing with a 4% chlorhexidine gluconate solution results in fewer wound infections as compared with povidoneiodine when used for vaginal antisepsis prior to cesarean delivery and (2) to compare rates of patient reported side-effects associated with vaginal application of 4% chlorhexidine gluconate solution and 10% povidone-iodine. STUDY DESIGN: This is a block randomized, comparator-controlled, open-label trial. Women undergoing nonemergent cesarean delivery were randomized to receive vaginal cleansing with either 4% chlorhexidine solution or 10% povidone-iodine solution prior to skin incision. The primary outcome was wound site infection occurring within 14 days of cesarean delivery including superficial or deep surgical site infection. Secondary outcomes included rates of endometritis, postoperative fever, and side effects (vaginal dryness, irritation, and desquamitization) occurring within 14 days of cesarean delivery. Risks were reported as odds ratios with 95% confidence intervals, with P < .05 considered as significant.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Surgical site infections are the most common and easily preventable infections complicating surgeries. CDC recommends certain bundle interventions for the prevention of SSIs. Hence the present study was undertaken to see the effectiveness and feasibility of the bundle interventions in the elective caesarean sections and caesarean hysterectomies.Methods: A total of 600 patients were taken. Bundled interventions were applied in 278 caesarean sections and 26 caesarean hysterectomies. Routine care was implemented in 262 caesarean sections and 34 caesarean hysterectomies. Rate of SSI, risk factors associated and treatment outcomes were studied.Results: 8 out of 304 cases of the bundled intervention group developed SSI, giving a rate of 2.6%. 52 cases out of 296 in the routine care group developed SSI, the SSI rate being 17.5%. Anemia and diabetes were the most common risk factors.Conclusions: Adherence to bundled interventions can significantly and easily reduce the incidence...