Effect of Vaginal Cleansing with Povidone Iodine Solution before Cesarean Section on Postoperative Endometritis Infection

Abstract

Background: Cesarean section (CS) continues to be the surgical intervention most often performed in obstetrics, with a daily increasing frequency of use. The risk for all postpartum infections is increased in CS compared to vaginal delivery. Infectious complications developing in the aftermath of CS are one of the main causes of maternal morbidity. So, the aim of this study was to investigate the effect of vaginal cleansing with Povidone Iodine solution before cesarean section on postoperative Endometritis Infection . Design: A quasi- experimental design was utilized in this study. Setting: This study was conducted at the operating room of Obstetrics and Gynecologic Department in Beni-Seuf University Hospital from the period of May 2019 until August 2019. The study Subjects included 200 pregnant women undergoing elective cesarean delivery, who were selected by purposive sampling technique. then divided into control and study group 100 per each group. The study group receive vaginal cleansing before cesarean section by antiseptic iodine solution 10% and standard abdominal scrub. Control group receive standard abdominal scrub only. Tools was used of data collection included; 1st tool: Structured interview questionnaire was designed by the researchers and included demographic characteristics and data related to the participants’ clinical profile 2nd tool: Postpartum follow-up checklist to assess presence or absence of the post CS infectious morbidity such as; endometritis (lower abdomen pain and a smelly vaginal discharge), febrile morbidity, and incisional site infection.3rd tool: Numericаl rating scale (NRЅ). Study results: Shows there was statistically significant difference regards fever and a smelly vaginal discharge among both groups, while there was no statistically significant difference was found regards wound infection and lower abdomen pain. Conclusion: Preoperative vaginal cleansing using antiseptic iodine solution 10% was an effective practice for reducing post cesarean endometritis where overall post cesarean infectious morbidity rate was lower among study group compared to control those exposed to routine care alone; supporting the study hypothesis. Recommendations: Physicians and Nurses should be used antiseptic povidone-Iodine 10% or vaginal cleaning as regular practice before cesarean deliveries. Apply vaginal preparation with anti septic solution before C.S operation for high risk group for infection as premature rupture of membranes, diabetes, and anemia.