Third prize manuscriptPost-cesarean related infection and vaginal preparation with povidone–iodine revisited☆
Section snippets
Materials and methods
The study was designed as a randomized, blinded, controlled, clinical trial of the benefits of vaginal preparation with povidone-iodine in patients undergoing cesarean delivery. The study was conducted between March 2000 and July 2001 at University Medical Center (Lubbock, TX), a tertiary care center with >2,000 births per year. Infection rates at this institution ranged between 10 and 30% over the past 4 years. A power analysis determined that a total of 160 subjects (80 cases, 80 controls)
Results
No difference was seen in the patient populations for the factors measured, including maternal age, parity, maternal weight, rupture of membranes, vaginal examinations, operating-room time, or length of stay postpartum (Table 1).
A total of 15 patients were diagnosed with endometritis (9.4%). Only 2 patients treated with povidone iodine (2.5%) developed endometritis, as compared with 13 patients receiving the control saline treatment (16.3%). When compared statistically, this translates to a
Discussion
Previous studies have reported morbidity due to infection as the most common complication of cesarean delivery. This may result in the following: increased discomfort, pain, extended hospital stay, and disappointment with the birth experience. Such complications often lead to increased hospital charges, which have been conservatively estimated to cost the health care system (and the patients) over one-half billion dollars annually.5, 6
The present study suggests that vaginal preparation with
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Cited by (26)
Vaginal cleansing before unscheduled cesarean delivery to reduce infection: a randomized clinical trial
2023, American Journal of Obstetrics and GynecologyThe cesarean procedure: Guidelines for clinical practice from the French College of Obstetricians and Gynecologists
2023, Gynecologie Obstetrique Fertilite et SenologiePovidone-iodine 1% is the most effective vaginal antiseptic for preventing post-cesarean endometritis: a systematic review and network meta-analysis
2019, American Journal of Obstetrics and GynecologyVaginal cleansing with chlorhexidine gluconate or povidone-iodine prior to cesarean delivery: a randomized comparator-controlled trial
2019, American Journal of Obstetrics and Gynecology MFMCitation Excerpt :After conducting a subanalysis, our results showed that women in either the povidone-iodine or chlorohexidine arm with ruptured membranes had similar rates of primary and secondary outcomes. This is consistent with a 2018 Cochrane review that showed that there was insufficient evidence to suggest that women with ruptured membranes prior to cesarean delivery benefit more from vaginal cleansing compared with those without ruptured membranes.1,19-21 However, a recent meta-analysis by Berghella and colleagues22 found that vaginal cleansing prior to cesarean delivery reduced the incidence of endometritis.
Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial
2010, American Journal of Obstetrics and GynecologyCitation Excerpt :Composite outcomes are often used in obstetric trials and have several advantages, including statistical and resource efficiency.22 The group of Guzman et al5 reported a smaller trial using povidone iodine and reported a reduced rate of postcesarean related infections, measured as a composite outcome. Another group found a reduction in endometritis in a sample size similar to our study.16
VAGINAL CLEANSING BEFORE EMERGENCY CESAREAN SECTION AND POST-OPERATIVE INFECTIOUS MORBIDITY; CLINICAL TRIAL IN A LOW RESOURCE SETTING
2023, Journal of Postgraduate Medical Institute
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Presented in Part at the ACOG District VII Meeting, Tulsa, OK, September 2001.