Vaginal Cleansing with Antiseptic Solution Before Caesarean Delivery

Abstract

Objective: To evaluate the effectiveness of vaginal cleansing with antiseptic solution before C section to prevent the infectious morbidity.

Methodology: This randomized controlled trial was carried out at Obstetrics and gynecology department of Patel Hospital Karachi from June 2021 to November 2021. Women with term and singleton pregnancy, aged 18 to 40 years, and scheduled to caesarean delivery were included. All the patients were randomly assigned to two groups: the intervention group (vaginal cleansing) before the C-section and the control group (without vaginal cleansing). The effectiveness was assessed based on the wound infections, prolonged hospital stays, and the need for additional antibiotics within 5 to 10 days post C-section. The SPSS version 26 was used to data entry and analysis.

Results: Overall 100 women were enrolled and equally divided in two groups with almost similar mean age of 29.26 years and 28.78 years respectively (p = 0.718). The postoperative infectious was some lower in the interventional group 4% in contrast to control group 12% p = 0.140. Post post-operative fever and endometritis were also less common in the interventional group (2% and 2%) compared to the to control group (4% and 6%) respectively p=0.558. However, the rate of readmission was rare, only in one patient of control group p = 0.315, mean hospital stay was significantly lower in the interventional group 2.84 days, compared to the control group 3.55 days, p = 0.001. Generally, findings indicated that the postoperative infectious outcomes tended to be lower with the vaginal cleansing.

Conclusion: The vaginal cleansing with an antiseptic solution immediately before C-section reduces postoperative infectious morbidity, suggesting that preoperative vaginal cleansing into routine cesarean delivery protocols could be a simple and effective technique to improve maternal outcomes.