Vaginal cleansing with povidone-iodine or chlorhexidine solution compared to saline or not cleansing immediately before cesarean delivery likely reduces the risk of post-cesarean endometritis, according to a recent Cochrane review. The review included 11 randomized controlled studies with 3,403 women undergoing cesarean section. The quality of the evidence was moderate for the reported outcomes. Among the findings:
- Vaginal preparation with antiseptic solution immediately before cesarean delivery likely reduces the incidence of post-cesarean endometritis from 8.7% to 3.8%.
- Risks of postoperative fever and postoperative wound infection may be slightly lowered by antiseptic preparation.
- No adverse effects were reported with either the povidone-iodine or chlorhexidine vaginal cleansing.
Haas DM, Morgan S, Contreras K, Enders S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD007892. doi:10.1002/14651858.CD007892.pub6.
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Term Cesarean Delivery & Subsequent Preterm Delivery, Am J Obstet Gynecol; ePub 2019 Feb 22; Vahanian, et al