Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial

Am J Obstet Gynecol. 2010 Mar;202(3):310.e1-6. doi: 10.1016/j.ajog.2010.01.005.


Objective: The objective of the study was to determine whether vaginal preparation with povidone iodine before cesarean delivery decreased the risk of postoperative maternal morbidities.

Study design: The design of the study was a randomized, controlled trial in women undergoing cesarean delivery with subjects assigned to have a preoperative vaginal cleansing with povidone iodine or to a standard care group (no vaginal wash). The primary outcome was a composite of postoperative fever, endometritis, sepsis, readmission, wound infection, or complication.

Results: There were 155 vaginal cleansing subjects and 145 control subjects. Overall, 9.0% developed the composite outcome, with fewer women in the cleansing group (6.5%) compared with the control group (11.7%), although the difference was not statistically significant (relative risk, 0.55; 95% confidence interval, 0.26-1.11; P = .11). Length of surgery, being in labor, and having a dilated cervix were all associated with the composite morbidity outcome.

Conclusion: Vaginal cleansing with povidone iodine before cesarean delivery may decrease postoperative morbidities, although the reduction is not statistically significant.

Trial registration: NCT00386477.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / administration & dosage*
  • Cesarean Section*
  • Endometritis / prevention & control
  • Female
  • Fever / prevention & control
  • Gravidity
  • Humans
  • Labor Stage, First
  • Labor, Obstetric
  • Parity
  • Patient Readmission
  • Postoperative Complications / prevention & control*
  • Povidone-Iodine / administration & dosage*
  • Pregnancy
  • Preoperative Care*
  • Sepsis / prevention & control
  • Surgical Stapling
  • Surgical Wound Infection / prevention & control
  • Sutures
  • Vagina / microbiology*


  • Anti-Infective Agents, Local
  • Povidone-Iodine

Associated data