The Use of 0.2% Chlorhexidine Gluconate Solution Compared with 10% Povidone Iodine Solution as Anti-septic in Curettage Measure in Case of Early Pregnancy Failure

Abstract

Background: Before aseptic techniques were widely used, the incidence of infections from vaginal surgery was very high at around 30% to 40%. In addition to antimicrobial prophylaxis, preparation of surgical sites with povidone iodine has been widely recommended. Another surgical antiseptic is chlorhexidine gluconate, which has various clinical uses. Evidence-based research shows that chlorhexidine gluconate is safe and effective as a preoperative antiseptic. The vagina has a mucosal structure with squamous epithelium without keratinization which has protective and secretion functions. Meanwhile the skin has a squamous epithelium with keratinization. The vagina also has several physiological conditions that have a protective effect on the vagina itself including pH conditions. Furthermore, chlorhexidine gluconate is suspected to have a pH that is almost similar to the physiological pH of the vagina.
 Method: This study was a randomized clinical trial (RCT). It compared the use of chlorhexidine gluconate as an antiseptic in the action of curettage in cases of early pregnancy failure with the use of povidone iodine.
 Result: The mean comfort score at 24 hours and 3 days on chlorhexidine gluconate was lower than povidone iodine but did not show a significant difference (p> 0.05), whereas on the 7th day it had the same comfort score. There was a decrease in 24 hours (0.70 vs. 0.2), the accumulation of decreases in 3 days (1.35 vs. 0.75) and 7 days (1.60 vs. 1.30) was higher in chlorhexidine gluconate compared to povidone iodine, but the difference is not statistically significant.
 Conclusion: Chlorhexidine gluconate provides the same effectiveness compared to povidone iodine in curettage cases in cases of early pregnancy failure. The use of chlorhexidine gluconate can provide better comfort compared to povidone iodine in the aforementioned case, but does not differ statistically.
 Keywords: Antiseptic, Chlorhexidine gluconate, Povidone iodine, Curettage