VAGINAL PREPARATION WITH ANTISEPTIC SOLUTION (POVIDONE IODINE 10%) BEFORE CESAREAN SECTION FOR PREVENTING POSTPARTUM INFECTIONS: A PROSPECTIVE OBSERVATIVE COHORT STUDY
Mahmoud Mohamed Ghaleb, Hadeer Khoubza Abdelrheem, Salah Taha Fayed
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
Background: Endometritis and wound infection are common and significant postoperative morbidities with respect to patient cost, prolonged hospital stay, use of parenteral antibiotics, and patient discomfort. The risk of postcesarean infectious morbidity is reported to range from 5–85%, with the highest rate among indigent patients 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 to reduce the bacterial exposure of the endometrium and other maternal tissues during caesarean section.