Pre-Caesarean Section Vaginal Preparation with Chlorhexidine Solution in Preventing Puerperal Infectious Morbidities:...

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Surgical Safety

Background:

• Peripartum infections contribute significantly to maternal mortality globally, especially in low-income countries.
• Antiseptic vaginal preparation before cesarean delivery may reduce post-operative infectious complications.

Purpose of the Study:

• To assess the efficacy of 0.3% chlorhexidine vaginal preparation in preventing endometritis, surgical site infection, and post-operative fever after emergency cesarean sections.

Main Methods:

• A prospective randomized controlled trial involved 240 women undergoing emergency cesarean sections.
• Participants were randomized to receive vaginal preparation with 0.3% chlorhexidine gluconate or normal saline (placebo).
• Post-operative follow-up monitored for clinical signs of puerperal infectious morbidities.

Main Results:

• Endometritis rates were significantly lower in the chlorhexidine group (5.0%) compared to the placebo group (13.3%) (p=0.042).
• The risk reduction for endometritis was 62% with chlorhexidine use.
• Reductions in post-operative fever and surgical site infection were observed but not statistically significant.

Conclusions:

• Pre-cesarean vaginal preparation with 0.3% chlorhexidine solution effectively reduces the rate and risk of post-operative endometritis.
• Chlorhexidine vaginal preparation shows promise as an intervention to decrease infectious morbidities following cesarean delivery.