Antiseptic vaginal preparation before caesarean section effective for preventing postoperative endometritis

January 01, 0001

Antiseptic vaginal preparation before caesarean section effective for preventing postoperative endometritis

Clinical Question: How effective is vaginal cleansing before caesarean section with an antiseptic solution for preventing postoperative infections?

Bottom line: Vaginal preparation with an antiseptic solution (povidone-iodine) immediately before caesarean delivery reduced the risk of postoperative endometritis (from 9.4% to 5.2%). This benefit was particularly apparent for women undergoing caesarean delivery with ruptured membranes (from 15.4% to 1.4%). Vaginal cleansing did not reduce fever or wound complications. No adverse events such as allergy or irritation were noted. Pre-operative vaginal cleansing is a simple inexpensive intervention.

Caveat:This review is limited by the somewhat small number of trials (4). Information on other methods or other solutions for vaginal cleansing was lacking.

Context:Caesarean deliveries are common today, with almost 1 in 3 babies born by caesarean in some countries. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates caesarean deliveries.

Cochrane Systematic Review: Haas DM et al. Vaginal preparation with antiseptic solution before caesarean section for preventing postoperative infections. Cochrane Reviews 2010, Issue 3. Article No. CD007892. DOI: 10.1002/14651858.CD007892.pub2. This review contains 4 studies involving 1361 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 267, May 2010. .
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: W. Pregnancy, Family Planning. Keywords: cesarean section, antiseptic, endometritis, postpartum fever
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 26 October 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.