Key result
Preoperative vaginal washing with saline or povidone-iodine cuts postpartum endometritis up to ~88% vs routine care.
Why the study?
Cesarean delivery is the single most important risk factor for postpartum endometritis, and preventive strategies are needed to reduce this risk.
Does vaginal washing with saline or povidone-iodine prevent endometritis in women undergoing elective cesarean delivery?
RCT (n=150)
Numbered patient name list (even/odd numbers)
No
Does vaginal washing with saline or povidone-iodine prevent endometritis in women undergoing elective cesarean delivery?
Vaginal washing with povidone-iodine or saline immediately prior to elective cesarean delivery significantly reduces the rate of postpartum endometritis.
Answers are grounded in this paper and cite their sources.
Supports preoperative vaginal washing before elective cesarean; confirms efficacy for reducing postpartum endometritis in this RCT.
Objective : The single most important risk factor for postpartum endometritis is cesarean delivery. Aim: This study aimed to evaluate the effect of prophylactic preoperative nursing interventions on prevention of endometritis among women undergoing elective caesarean delivery. Methods : Setting: This study was conducted in Operating Rooms, Postnatal Wards and Clinics of the Obstetrics and Gynecology Department at Mansoura University Hospital. Study Design: A randomized controlled clinical trial was utilized. Sample: A purposive sample of 150 parturient women undergoing elective cesarean section were randomly chosen according to inclusion criteria and then divided into three equal groups of 50 parturient women. Group one the control group received routine preoperative abdominal and thigh scrub with 10% Povidone Iodine and taken standard antibiotic regiment. There were two intervention groups; Group two participants received vaginal washing with 0.9% saline solution and group three participants received vaginal washing with 10% Povidone–iodine solution in addition to routine preoperative care. Results : The findings of this study revealed that the risk of developing post-elective caesarean delivery endometritis was significantly lower in the intervention groups compared to the control group ( P < .05). Conclusions : Vaginal washing with Povidone-iodine or saline solution immediately prior cesarean delivery significantly reduces the rate of post-elective caesarean delivery endometritis. Recommendation: Vaginal washing immediately prior to cesarean delivery should be a routine care to reduce the risk of postpartum endometritis.
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Khedr et al. (2016) conducted an RCT in Elective cesarean delivery (n=150). Vaginal washing with 0.9% saline or 10% povidone-iodine vs. Routine preoperative care without vaginal washing was evaluated on Postpartum endometritis at first postnatal follow-up (7 days) (p=0.014). Preoperative vaginal washing with 0.9% saline or 10% povidone-iodine significantly reduced the rate of postpartum endometritis at one week compared to routine care (2% and 4% vs 16%, respectively).
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