title: Does vaginal preparation with povidone-iodine prior to caesarean delivery reduce the risk of endometritis? A randomized controlled trial.
abstract: OBJECTIVE
  The purpose of the present study was to determine whether the vaginal preparation with povidone-iodine prior to caesarean delivery decreased the incidence of postpartum endometritis.
  
  
  METHODS
  The present study was a prospective randomized controlled trial in which subjects received a vaginal preparation with povidone-iodine solution immediately prior to caesarean delivery or received no vaginal preparation. The primary outcome measure was the rate of postpartum endometritis.
  
  
  RESULTS
  A significant decrease in post-caesarean endometritis was noted in the group that received the povidone-iodine vaginal preparation (n = 334) compared with the control group (n = 336) [6.9 vs. 11.6%; RR = 1.69; 95% CI = 1.03-2.76]. No statistically significant differences in the incidence of endometritis were noted between the experimental and control groups among women who were not in labor at the time of the caesarean delivery [9.2 vs. 8.6%; RR = 1.05; 95% CI = 0.58-1.90], and no differences were found between groups when women with ruptured membranes were excluded from the analysis [9.6 vs. 6.7%; RR = 1.39; 95% CI = 0.78-2.47].
  
  
  CONCLUSIONS
  Vaginal preparation with povidone-iodine solution immediately prior to a caesarean delivery reduces the risk of post-operative endometritis. This preemptive measure was only found to be beneficial in women whose membranes had ruptured and those who were in labor prior to caesarean surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Kanuni Sultan Süleyman Teaching Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yildirim
authors.forename: Kemal
authors.initials: K
authors.lastname: Güngördük
authors.forename: Osman
authors.initials: O
authors.lastname: Asicioğlu
authors.forename: Toygun
authors.initials: T
authors.lastname: Basaran
authors.forename: Osman
authors.initials: O
authors.lastname: Temizkan
authors.forename: Inci
authors.initials: I
authors.lastname: Davas
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gulkilik
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000465:Algorithms; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002585:Cesarean Section / Q000009:adverse effects*; D004716:Endometritis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011206:Povidone-Iodine / Q000008:administration & dosage* / Q000494:pharmacology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D044364:Vaginal Douching; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine