- Vaginal povidone-iodine prior to cesarean delivery (CD) is the best choice for prophylaxis against postpartum endometritis, fever, and wound infections.
Why this matters
- These data support the use of 1% povidone-iodine application in women undergoing planned CD, as well as CD after membranes rupture and/or labor.
- CD is a common surgery, and reducing risks for complications will improve maternal health.
- 1% povidone-iodine reduced the rate of endometritis (OR, 0.43; 95% CI, 0.28-0.64) compared with no treatment.
- Chlorhexidine reduced risk for endometritis, but results not statistically significant (OR, 0.71; 95% CI, 0.38-1.33).
- Povidone-iodine reduced risks for postpartum fever and wound infection (OR, 0.61; 95% CI, 0.48-0.78).
- Systematic review and meta-analysis.
- 23 studies using various vaginal antiseptic preparations prior to CD were included.
- Primary outcome was endometritis (temperature >38°C, uterine tenderness, and/or foul smelling vaginal discharge).
- Secondary outcomes included postoperative fever and wound infection.
- Funding: Department of Obstetrics and Gynecology, University of Florida College of Medicine Jacksonville.
- Limitations related to limitations of original studies.
- Potential confounding factors and selection bias possible.