title: Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial.
abstract: OBJECTIVE
  To evaluate the efficacy of preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes on rates of postcesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection).
  
  
  METHODS
  This prospective randomized trial was conducted among 218 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization. After spinal anesthesia and catheterization under aseptic technique, the study group had preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes for about 1 min, while the control group did not. All cases received the prophylactic antibiotics and the usual abdominal scrub. All participants received the routine postoperative care without other interventions. Adverse postcesarean infectious morbidities such as endometritis, febrile morbidity and wound infection were observed at the time of hospital discharge and weekly for 6 weeks postpartum.
  
  
  RESULTS
  Both groups were matched regarding the baseline patients' characteristics (age, gestational age, BMI, operative time and postoperative hospital stay). Overall, post-CS infectious morbidity were significantly reduced from 24.4% in the control group to 8.8% in the intervention group; p value <0.05. Marked reduction was seen in the incidence of endometritis (13.2% in the control group versus 2.9% in the intervention group; p value <0.05). However, fever and wound infection showed no significant difference between both groups.
  
  
  CONCLUSIONS
  Cleansing the birth canal with chlorhexidine 0.25% wipes prior to elective CS appears to be effective in reducing rates of post-CS infectious morbidity mainly endometritis.
authors: a Department of Obstetrics and Gynecology , Suez Canal University , Ismailia , Egypt and.|b Department of Obstetrics and Gynecology , Taif University , Taif , Saudi Arabia.
authors: Magdy R
authors: MR
authors: Ahmed
authors: b Department of Obstetrics and Gynecology , Taif University , Taif , Saudi Arabia.
authors: Nisreen K
authors: NK
authors: Aref
authors: a Department of Obstetrics and Gynecology , Suez Canal University , Ismailia , Egypt and.
authors: Waleed A
authors: WA
authors: Sayed Ahmed
authors: b Department of Obstetrics and Gynecology , Taif University , Taif , Saudi Arabia.
authors: Farzana R
authors: FR
authors: Arain
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D002710:Chlorhexidine / Q000008:administration & dosage*; D004716:Endometritis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine
keywords: Cesarean section; chlorhexidine; infectious morbidity