The effect of vaginal cleansing performed with normal saline solution or povidone-iodine before elective caesarean section on postoperative maternal morbidity and infection: A prospective randomized controlled study

Objective: The present study was designed to determine the effect of vaginal cleansing performed with saline solution or povidone-iodine before elective cesarean section on postpartum maternal morbidity and postoperative infection. Patients and Methods: One hundred and eighty primiparae, awaiting elective caesarean section, were assigned into the following three groups, Group1 (saline solution vaginal cleansing for 30s, n:60); Group2 (povidone-iodine vaginal cleansing for 30s, n:60); Group3 (control group, n:60). Results: There were statistically significant differences between the 3 groups in terms of the median values for the postoperative C-reactive protein (CRP) and fever, and visual analogue scale (VAS) score (p<0.001). The median value for the postoperative CRP level was 26.5 mg/dl, 59.5mg/dl and 62.3mg/dl in the saline solution, povidone-iodine and control groups respectively. The median value for the VAS score was 3,4 and 4; the incidence of the patients with fever >38°C was 1.7%, 3.4% and 10% in the saline solution, povidone-iodine and control groups, respectively. Conclusion: Vaginal cleansing with normal saline solution or povidone-iodine before caesarean section significantly reduced postoperative pain, fever, and CRP levels. Cleansing of the vagina before cesarean section clinically reduced the number of postcaesarean wound site infections, and endometritis; however, the reduction was not statistically significant.