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INFEXIT: Implementing vaginal disinfection prior to cesarean section
S T M Cobelens1, K van den Berg2, M G van Pampus1
1Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands.
European Journal of Obstetrics, Gynecology, and Reproductive Biology
|October 18, 2022
Summary
Adding vaginal disinfection with povidone-iodine before cesarean sections significantly reduced post-cesarean infections and hospital readmissions. This quality improvement measure was well-implemented, showing positive outcomes for maternal health and healthcare costs.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Prevention
- Surgical Quality Improvement
Background:
- Cesarean sections carry risks of post-operative infections.
- Reducing these infections can decrease hospital readmissions and healthcare costs.
Purpose of the Study:
- To assess the implementation rate of vaginal disinfection prior to cesarean section.
- To evaluate the impact of this intervention on post-cesarean endometritis, wound infections, and postoperative fever.
- To determine the effect on hospital readmissions.
Main Methods:
- An intervention study comparing outcomes before and after implementing 1% povidone-iodine vaginal disinfection.
- Two groups of women undergoing cesarean section were analyzed: pre-intervention (n=1384) and post-intervention (n=1246).
- Primary outcome was implementation rate; secondary outcomes included infection rates and hospital readmissions.
Main Results:
- Implementation rate reached 85.6%.
- A significant decrease in endometritis was observed in women with ruptured membranes (3.4% to 1.3%) and those in the second stage of labor (4.7% to 0.0%).
- Overall infection reduction led to a significant decrease in hospital readmissions (27 to 10).
Conclusions:
- Vaginal disinfection is an effective quality improvement measure for cesarean sections.
- The intervention demonstrated a significant reduction in endometritis for specific high-risk groups.
- This led to a clinically relevant decrease in hospital readmissions, indicating cost savings.
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