Preoperative vaginal preparation with povidone-iodine on post-caesarean infectious morbidity

Summary

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 × 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.

Keywords:

• Caesarean section
• endometritis
• febrile morbidity
• infection
• povidone-iodine

Acknowledgement

Our thanks go to the study volunteers, the nurses, residents and all the hardworking people in the research centre of the Guilan University of Medical Sciences, without whom this study would not have been possible.