Publication:

Effect of vaginal preparation before caesarean section on post operative infectious morbidity

Background Caesarean section (CS) is a common surgical procedure associated with postoperative infectious morbidities such as endometritis, wound infection, and urinary tract infection. Vaginal antiseptic preparation before CS has been proposed to reduce these complications by lowering bacterial load. This study aimed to evaluate the effect of vaginal preparation before CS on postoperative infectious morbidity.

Methods This prospective study involved pregnant women undergoing caesarean delivery. Participants were divided into two groups: one undergoing vaginal cleansing with antiseptic solutions (povidone-iodine or chlorhexidine) before surgery, and the other receiving no vaginal preparation.  Postoperative outcomes, including the incidence of endometritis, wound infections, urinary tract infections, and febrile morbidity, were recorded and compared between groups.

Results Vaginal preparation significantly reduced the incidence of postoperative infections. A notable decrease in endometritis rates was observed among women who received preoperative vaginal cleansing, especially in cases of labor or ruptured membranes. Similarly, wound infection rates and urinary tract infections were lower in the intervention group. No serious adverse reactions related to antiseptic use were reported. Both povidone-iodine and chlorhexidine proved effective, with slight advantages seen for chlorhexidine in reducing overall morbidity due to its longer antimicrobial action and lower mucosal irritation.

Conclusions Preoperative vaginal cleansing with antiseptics before caesarean delivery effectively reduces postoperative infectious morbidity, particularly endometritis. This simple, low-cost intervention is especially beneficial for high-risk cases, such as emergency CS s and cases with ruptured membranes. Routine adoption of vaginal preparation could enhance maternal outcomes and reduce healthcare burden.