The effect of vaginal cleansing performed with normal saline solution or povidone-iodine before elective caesarean section on postoperative maternal morbidity and infection; A prospective randomized controlled study

Abstract

Objective: The present study was designed to determine the effect of vaginal cleansing performed with saline solution or povidoneiodine before elective cesarean section on postpartum maternal morbidity and postoperative infection. Patients and Methods: One hundred and eighty primiparae, awaiting elective caesarean section, were assigned into the following three groups, Group1 (saline solution vaginal cleansing for 30s, n:60); Group2 (povidone-iodine vaginal cleansing for 30s, n:60); Group3 (control group, n:60). Results: There were statistically significant differences between the 3 groups in terms of the median values for the postoperative C-reactive protein (CRP) and fever, and visual analogue scale (VAS) score (p<0.001). The median value for the postoperative CRP level was 26.5 mg/dl, 59.5mg/dl and 62.3mg/dl in the saline solution, povidone-iodine and control groups respectively. The median value for the VAS score was 3,4 and 4; the incidence of the patients with fever >38°C was 1.7%, 3.4% and 10% in the saline solution, povidone-iodine and control groups, respectively. Conclusion: Vaginal cleansing with normal saline solution or povidone-iodine before caesarean section significantly reduced postoperative pain, fever, and CRP levels. Cleansing of the vagina before cesarean section clinically reduced the number of postcaesarean wound site infections, and endometritis; however, the reduction was not statistically significant.