Publication:

Efficacy of betadine vaginal toileting before caesarean section in postoperative infections

Background The objective of the current study was to evaluate the efficacy of preoperative betadine vaginal toileting in reducing post caesarean infections (endometritis, febrile illness, wound sepsis).

Methods This prospective longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 3 months among 200 women who underwent caesarean delivery. Inclusion criteria were defined as women undergoing caesarean section. Exclusion criteria included placenta previa, active genital herpes, cord prolapse, chorioamnionitis, allergy to iodine. After taking informed consent, subjects were divided into two groups by simple randomization method using computer generated random numbers- Group 1 (case) - subjects who underwent 5% povidone iodine sponge stick cleansing in all the fornices and walls of vagina for 30 seconds after foley’s catheter insertion and before abdominal scrubbing. Group 2 (control) - subjects who didn't receive betadine vaginal toileting before caesarean section Subjects were followed for 10 days postpartum (or till suture removal/ discharge from hospital, whichever was late). Demographic data, operative details and postoperative parameters were compared between the two groups.

Results Both groups were matched for baseline patients’ characteristics (age, BMI, gestational age, operative time). Women who received preoperative betadine vaginal toileting had markedly less incidence of endometritis (case-3%, control-10%, p 0.05) and wound sepsis (case-5%, control-12%, p>0.05) were found to be less but not significant between both groups.

Conclusions Preoperative vaginal cleansing helps in reducing postoperative morbidity by decreasing incidence of postoperative infection.