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.
Caveat: 
This review is limited by the somewhat small number of trials (4). Information on other methods or other solutions for vaginal cleansing was lacking.
Context: 
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#: 
CD007892
PEARLS No: 
267
Date: 
May, 2010
Authored by: 
Brian R McAvoy