Effect of preoperative vaginal cleansing with an antiseptic solution to reduce post caesarean infectious morbidity

Abstract

Objective: To determine the effectiveness of pre operative vaginal cleansing with an antiseptic solution to reduce post caesarean infectious morbidity.

Methods: An observational case control study was conducted at Department of Obstetrics and Gynaecology, Unit-III, Liaquat University Hospital, Hyderabad from February to July 2010. The 100 women in control group received the standard abdominal preparation only, while the 100 subjects in interventional group also received preoperative vaginal cleansing with 10% pyodine along with the usual abdominal scrub. All subjects received prophylactic antibiotic cover during the surgery. Maternal demographics, surgical parameters and infectious outcome were collected and data compiled on a pre-designed proforma and analysis was done using SPSS 15.

Results: The comparison between two groups did not show a significant difference in patient's demographics, labour and surgical variables. Post caesarean endometritis occurred in 1% of case group and 7% of controls (p value: <0.03). There was no measurable effect seen on development of fever and wound infection However, statistically significant reduction in overall composite morbidity i.e. p value: <0.02 and odds ratio 0.335 (CI=0.125-0.896) was seen in patients with vaginal cleansing group when compared with controls.

Conclusion: Preoperative vaginal cleansing with pyodine has reduced post caesarean infectious morbidities.