The effect of preoperative vaginal preparation with povidone-iodine on post-caesarean section infection

Objective: To evaluate the effect of preoperative vaginal antiseptic cleansing with Povidone-iodine on the occurrence of post-caesarean section infectious morbidity. Methodology: A single-blind randomized controlled study of 180 women who had preoperative vaginal preparation with povidone-iodine before emergency CS at the University of Ilorin teaching hospital during the study period, The primary outcome measures were fever, endometritis and wound infection. Analysis was done using Chi-square tests, t-tests and logistic regression. Results: The study result shows that the prevalence of post-caesarean section infection morbidity was 26.5%. There was a statistically significant difference in educational level attained and social class (p<0.001) between both groups. The incidence of post-caesarean infection was significantly lower among the subjects compared to the controls (16.3% vs.36.6%,p-0.003). Using univariate and multivariate binary logistic regression, PVP-I use and chorioamnionitis remain significant independent predictors of infectious morbidity. PVP-I is associated with lesser odds (OR; 0.307) while those with chorioamnionitis are eight times more likely to have a postoperative infection (p-0.006). Conclusion: The incidence of post-caesarean fever and endometritis was significantly reduced in those scrubbed with both abdominal and vaginal Povidone-iodine compared to those who had standard abdominal scrub alone for emergency caesarean section. Vaginal cleaning with Povidone-iodine is safe.