Prospective Study on Prevention of Post-Caesarean Endometritis by Vaginal Preparation with Povidone Iodine 1% Preoperatively in a Rural Tertiary Hospital in Central India.

Abstract

Background: There is trend towards increased caesarean deliveries in the modern era. One of the most common negative effects of caesarean births is post-operative infectious morbidity. In addition to antibiotic prophylaxis, it has long been advised to prepare the surgical site with povidone-iodine to reduce presence of bacterial and fungal organisms near the skin or vagina. We thus concentrated on researching use of 1% povidone iodine vaginally preoperatively to prevent post-caesarean section endometritis in our hospital.

Methods: This was a prospective, observational, case-control study. All pregnant women undergoing LSCS fulfilling the inclusion criterion were recruited and divided into two groups. All characteristics were recorded in specially designed Case Report Form, and patients were reviewed for 6 weeks for outcome measures. The data were analysed using Excel sheets, and Chi-square test and independent sample t-test were applied to analyse the statistical significance.

Results: The cases were found to have undergone significantly greater mean number of pelvic examinations than the controls (p value < 0.0001). Greater proportion of controls developed endometritis and fever than the cases, and this value was statistically significant (p < 0.05). Wound infection and post-LSCS CRP levels were greater among controls as compared to cases, but this was not statistically significant.

Conclusion: Incidence of post-caesarean endometritis and fever was significantly lower among cases as compared to controls. Application of povidone iodine is a simple and cost-effective method which can be implemented on a larger scale in order to reduce caesarean related morbidity.