ANALYSING THE EFFECTIVENESS OF VAGINAL CLEANSING PRIOR TO THE CAESAREAN – SECTION

 

Dr.Lovely Thomas ¹, Miss.Fifydani Shamsudin ²

1. Registrar in Obstetrics and Gynaecology  at CRH
2. Consultant in Obstetrics and Gynaecology at CRH

OBJECTIVE:

To assess the efficacy of vaginal preparation with antiseptics prior to caesarean section in preventing maternal peripartum infections.

Among the pregnant women undergoing caesarean section, does vaginal cleansing with an antiseptic agent before caesarean section, compared with no vaginal cleansing, prevent post- operative maternal infectious morbidities.

 

METHODS:

Vaginal cleaning with either povidone iodine or chlorhexidine at the time of catheterisation for caesarean section was implemented in a district hospital as per WHO recommendation. Data was collected 1 year after introduction of the vaginal preparation procedure prior to caesarean section and compared it with data collected prior to the implementation of the procedure .Data was collected retrospectively to assess the efficacy of vaginal preparation prior to caesarean section .

 

RESULTS:

1. Post-natal re-admissions with sepsis following caesarean section was reduced by 62.5% with the introduction of vaginal preparation prior to caesarean section.
2. Endometritis following caesarean section was reduced to 6.6% after implementation of vaginal cleansing procedure preceding caesarean section.
3. Post – caesarean section wound infection remained the same before and after the introduction of antiseptic vaginal cleaning before caesarean section.

 

CONCLUSIONS:

WHO recommendation of vaginal preparation before cesarean section has significantly reduced postnatal re-admissions with sepsis following caesarean section and also reduced the incidence of endometritis following caesarean section.

Vaginal preparation prior to caesarean section pertains to all women undergoing caesarean section including elective caesarean and emergency C section following failed trial of forceps.  Vaginal preparation is done for a duration of 30 seconds to 1minute following preoperative urinary bladder catheterisation to minimize woman’s discomfort.