Antiseptic vaginal preparation before caesarean section effective for preventing postoperative endometritis

Clinical question: 
How effective is vaginal cleansing before caesarean section with an antiseptic solution for preventing postoperative infections?
Bottom line: 
Vaginal preparation with an antiseptic solution (povidone-iodine) immediately before caesarean delivery reduced the risk of postoperative endometritis (from 9.4% to 5.2%). This benefit was particularly apparent for women undergoing caesarean delivery with ruptured membranes (from 15.4% to 1.4%). Vaginal cleansing did not reduce fever or wound complications. No adverse events such as allergy or irritation were noted. Pre-operative vaginal cleansing is a simple inexpensive intervention.
This review is limited by the somewhat small number of trials (4). Information on other methods or other solutions for vaginal cleansing was lacking.
Caesarean deliveries are common today, with almost 1 in 3 babies born by caesarean in some countries. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates caesarean deliveries.
Review CD#: 
May, 2010
Authored by: 
Brian R McAvoy