Effect of Preoperative Vaginal Cleansing With Povidone Iodine on Post-caesarean Maternal Infections at Kenyatta National Hospital; a Randomized Controlled Trial (original) (raw)
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Impact of preoperative vaginal preparation with povidone iodine on post cesarean infection
Caspian Journal of Reproductive Medicine, 2016
Background: Obtaining clinical methods in order to decrease the infectious morbidity of cesarean delivery is very important. The aim of this study was to determine the effect of preoperative vaginal preparation with antiseptic solution on post-caesarean infections. Methods: This study was conducted on 400 singleton term pregnant women undergoing elective cesarean delivery. The samples were randomized into two groups; experimental group, including women who received an additional preoperative vaginal cleansing with 10% povidone iodine; and a control group, including women who received only the standard abdominal preparation. All subjects received a single dose of prophylactic antibiotic and were investigated after cesarean delivery until the 6th postoperative weeks for postoperative fever, wound infection, or endometritis. Data were analyzed using SPSS software and the P value < 0.05 was considered significant. Results: The groups were similar in age, education level, body mass index, and parity. The operation variables such as the postoperative fever, wound infection, and endometritis were observed in the two groups, and the overall for these were found to be 6.0 %, 6.3%, and 6.5%, respectively. A total of 7.5% of the participants in the control group and 5.5% of the participants in the experimental group developed postoperative endometritis; but it was not statistically significant (relative risk= 0.86; 95% confidence interval, 0.61-1.21; P=0.417). Also, there was no significant difference in postoperative fever, wound infection between these women with and without preoperative vaginal cleansing with povidone. Conclusion: The findings of the present study indicated that vaginal cleansing with povidone iodine immediately prior to elective cesarean delivery did not decrease the post-caesarean infection rates and the incidence of endometritis in low-risk women.
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...
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...
Preoperative vaginal preparation with povidone-iodine on post-caesarean infectious morbidity
Journal of Obstetrics and Gynaecology, 2011
The commonest complication associated with caesarean section is infection. The aim of this study is to investigate the effect of vaginal preparation with povidone-iodine on post-caesarean infection. In this clinical trial, 568 patients were selected for two groups: a treatment group and a control group, each with 284 patients. A vaginal scrub was performed before the routine abdominal scrub, with two 4 6 4 cm sponge sticks saturated with povidone-iodine solution, rotated in the vagina for about 30 s. In the control group, only the abdominal scrub was performed. Patients received a single dose of prophylactic antibiotics, and were reviewed for 6 weeks to look for predefined variables. Post-caesarean endometritis occurred less frequently in the treatment group than in the control group (2.5% vs 1.4%). There was no significant difference for febrile morbidity and wound infection in the two groups. The adjusted odds ratio for endometritis after vaginal preparation was 0.03 (95% CI: 0.008-0.7). Vaginal preparation with povidone-iodine may decrease the risk of post-caesarean endometritis.
Clinical Infection and Immunity, 2019
Background: Cesarean delivery is the most common major surgical procedure done by obstetricians. The rate of post-cesarean infectious morbidities is still unacceptably high despite the preoperative skin preparation and antibiotic use. There is evidence that vaginal cleansing prior to cesarean delivery decreases the risk of maternal infectious morbidities. This evidence, however, does not guide to the choice of the optimal antiseptic agent. The objective of the study was to evaluate the efficacy of abdominal and vaginal preparation with chlorhexidine compared to povidone-iodine prior to cesarean delivery in the reduction of post-cesarean infectious morbidities. Methods: This was a single-center randomized controlled trial. Patients undergoing cesarean delivery were randomly assigned to preoperative vaginal and skin preparation with either chlorhexidine or povidone-iodine in addition to the standard preoperative antibiotic prophylaxis. The primary outcome was a composite of postoperative infectious morbidity (fever, endometritis and wound infection) occurring within 30 days of the cesarean delivery. Results: In the period from February 2018 through February 2019, a total of 333 patients were recruited; 159 patients were assigned to chlorhexidine group and 174 to povidone-iodine group. Clinically there was a higher reduction of composite infectious morbidity in the group receiving chlorhexidine preparation when compared to povidone-iodine group; however, this did not reach statistical significance (7 (4.4%) vs. 14 (8.0%) respectively, P = 0.17). Nonetheless, a significant difference could be elicited in less number of clinic follow-up visits with the use of chlorhexidine. Conclusion: The frequency of postpartum infectious morbidity in the entire cohort was lower than expected. This might be the effect of vaginal cleansing (irrespective of the antiseptic used). The use of chlorhexidine or povidone-iodine for combined abdominal and vagi-nal preparation was not different in reducing post-cesarean infectious morbidities.
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.
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.
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 ...