Vaginal preparation with antiseptic solution before caesarean section for preventing postoperative infections

Vaginal preparation with povidone-iodine or chlorhexidine solution immediately before caesarean delivery appears to reduce the risk of postoperative endometritis compared with saline or no preparation.

The quality ov evidence is downgraded by study limitations (unclear allocation concealment or blinding in half of the studies).

A Cochrane review included 11 studies with a total of 3403 subjects. The risk of bias was generally low, with the quality of most of the studies being high. Vaginal preparation (povidone-iodine, chlorhexidine, benzalkonium chloride) immediately before cesarean delivery significantly reduced the incidence of post-cesarean endometritis from 8.7% in control groups to 3.8% in vaginal cleansing groups (average risk ratio (RR) 0.36, 95% CI 0.20 to 0.63; 10 trials, n=3283). The risk reduction appeared stronger for women who were already in labor at the time of the cesarean delivery and for women with ruptured membranes.

Ədəbiyyat

1. Haas DM, Morgan S, Contreras K et al. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev 2018;(7):CD007892.