الفهرس 
Post partum Infectious MorbidityOnly 14 pages are availabe for public view
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Abstract
Vaginal preparation has been shown to decrease the quantitative load of vaginal microorganisms as well as to remove certain species of bacteria. There is a limited information in the literature regarding the use of preoperative vaginal preparation with povidone-iodine as
a prophylactic measure against postcesarean infectious morbidity.
The aim of the study was to determine the effect of preoperative vaginal preparation with povidone-iodine on the incidence of post-cesarean endometritis, in women underwent non emergent cesarean delivery.
This study was conducted at Ain-Shams University maternity Hospital, during the period form August 2008 to February 2009.
Four hundred patients were recruited in the study. Two hundred were assigned randomly to the group A, and two hundred were assigned randomly to group B.
Group A received the standard abdominal skin preparation with povidone-iodine plus an additional 30 seconds vaginal scrub with povidone iodine solution.
Group B received only the standard abdominal skin preparation with povidone-iodine solution.
All patients of both groups received parenteral antibiotic prophylaxis in the form of 1 gram first generation cephalosporin at the time of skin incision.
There was no significant difference between the two groups as regards the demographic data, antepartum data and the risk factors for developing postcesarean infectious morbidity.
In this study, the incidence of post cesarean endometritis was significantly lower in groups A than in groups B (10% versus 21% respectively with P value < 0.05).
In this study, there was no statistical significant difference between the two groups in the incidence of occurrence of wound infection and the study lack the power to draw any conclusion about the effect of vaginal preparation on the incidence of wound infection as the incidence of wound infection was much more lower than endometritis.
In conclusion, preoperative vaginal preparation with povidone-iodine in conjunction with the standard abdominal preparation resulted in a reduction in the incidence of postcesarean endometritis by about 50%. However, no significant benefit on the incidence of wound infection and febrile morbidity was demonstrated.