Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial

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 preg...

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Published in:The journal of maternal-fetal & neonatal medicine 2017-06, Vol.30 (12), p.1484-1487
Main Authors: Ahmed, Magdy R., Aref, Nisreen K., Sayed Ahmed, Waleed A., Arain, Farzana R.
Format: Article
Language:English
Subjects:
Administration, Intravaginal
Adult
Anti-Infective Agents, Local - administration & dosage
Antibiotic Prophylaxis - methods
Case-Control Studies
Cesarean section
Cesarean Section - adverse effects
chlorhexidine
Chlorhexidine - administration & dosage
Endometritis - prevention & control
Female
Humans
infectious morbidity
Pregnancy
Prospective Studies
Surgical Wound Infection - prevention & control
Young Adult
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cited_by cdi_FETCH-LOGICAL-c366t-e7ac8cab269deee078e9049db9172849c06ca164c777991f23866fec239598413
cites cdi_FETCH-LOGICAL-c366t-e7ac8cab269deee078e9049db9172849c06ca164c777991f23866fec239598413
container_end_page 1487
container_issue 12
container_start_page 1484
container_title The journal of maternal-fetal & neonatal medicine
container_volume 30
creator Ahmed, Magdy R.
Aref, Nisreen K.
Sayed Ahmed, Waleed A.
Arain, Farzana R.
description 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 
doi_str_mv 10.1080/14767058.2016.1219996
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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 &lt;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 &lt;0.05). However, fever and wound infection showed no significant difference between both groups. Conclusion: 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.</description><identifier>ISSN: 1476-7058</identifier><identifier>EISSN: 1476-4954</identifier><identifier>DOI: 10.1080/14767058.2016.1219996</identifier><identifier>PMID: 27583685</identifier><language>eng</language><publisher>England: Taylor &amp; Francis</publisher><subject>Administration, Intravaginal ; Adult ; Anti-Infective Agents, Local - administration &amp; dosage ; Antibiotic Prophylaxis - methods ; Case-Control Studies ; Cesarean section ; Cesarean Section - adverse effects ; chlorhexidine ; Chlorhexidine - administration &amp; dosage ; Endometritis - prevention &amp; control ; Female ; Humans ; infectious morbidity ; Pregnancy ; Prospective Studies ; Surgical Wound Infection - prevention &amp; control ; Young Adult</subject><ispartof>The journal of maternal-fetal &amp; neonatal medicine, 2017-06, Vol.30 (12), p.1484-1487</ispartof><rights>2016 Informa UK Limited, trading as Taylor &amp; Francis Group. 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-e7ac8cab269deee078e9049db9172849c06ca164c777991f23866fec239598413</citedby><cites>FETCH-LOGICAL-c366t-e7ac8cab269deee078e9049db9172849c06ca164c777991f23866fec239598413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27583685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ahmed, Magdy R.</creatorcontrib><creatorcontrib>Aref, Nisreen K.</creatorcontrib><creatorcontrib>Sayed Ahmed, Waleed A.</creatorcontrib><creatorcontrib>Arain, Farzana R.</creatorcontrib><title>Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial</title><title>The journal of maternal-fetal &amp; neonatal medicine</title><addtitle>J Matern Fetal Neonatal Med</addtitle><description>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 &lt;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 &lt;0.05). However, fever and wound infection showed no significant difference between both groups. 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A randomized trial</atitle><jtitle>The journal of maternal-fetal &amp; neonatal medicine</jtitle><addtitle>J Matern Fetal Neonatal Med</addtitle><date>2017-06-18</date><risdate>2017</risdate><volume>30</volume><issue>12</issue><spage>1484</spage><epage>1487</epage><pages>1484-1487</pages><issn>1476-7058</issn><eissn>1476-4954</eissn><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 &lt;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 &lt;0.05). However, fever and wound infection showed no significant difference between both groups. 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source Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list)
subjects Administration, Intravaginal
Adult
Anti-Infective Agents, Local - administration & dosage
Antibiotic Prophylaxis - methods
Case-Control Studies
Cesarean section
Cesarean Section - adverse effects
chlorhexidine
Chlorhexidine - administration & dosage
Endometritis - prevention & control
Female
Humans
infectious morbidity
Pregnancy
Prospective Studies
Surgical Wound Infection - prevention & control
Young Adult
title Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial
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