Presurgical irrigation with Povidone-iodine may prevent endometritis after cesarean, finds AJOG study

Florida: Presurgical vaginal irrigation with povidone-iodine 1% reduced the risk of endometritis, postoperative wound infections, and fever most effectively in women who underwent cesarean delivery, finds a recent study published in the American Journal of Obstetrics & Gynecology.

According to the study, povidone-iodine 1% performed most effectively as a vaginal antiseptic among the other antiseptics used in the study, to prevent post-cesarean endometritis.

Endometritis is the inflammation of endometrium (inner lining of the uterus). It is the most common cause of the infection that can occur up to 6 weeks after childbirth. Its occurrence is much more common after cesarean section births. The condition, although, not life-threatening, but it becomes important to get it treated as soon as possible. Symptoms include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge.

Jared T. Roeckner, Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, and colleague reviewed the literature systematically and quantitated and summarized indirectly the comparative efficacy of antiseptic formulations and their concentrations that are used for the preparation of the vagina before cesarean delivery in the prevention of endometritis and other infectious complications.

The researchers searched for online databases from inception to November 2018. They selected randomized clinical trials of patients who underwent surgical preparation of the vagina with antiseptic formulations before cesarean delivery with the aim of reducing the risk of infectious morbidity.