Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial
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...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2010-03, Vol.202 (3), p.310.e1-310.e6 |
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| container_title | American journal of obstetrics and gynecology |
| container_volume | 202 |
| creator | Haas, David M., MD, MS Pazouki, Fatemeh, MD Smith, Ronda R Fry, Amy M., MD Podzielinski, Iwona, MD Al-Darei, Sarah M., MD Golichowski, Alan M., MD, PhD |
| description | 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. |
| doi_str_mv | 10.1016/j.ajog.2010.01.005 |
| format | Article |
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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.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2010.01.005</identifier><identifier>PMID: 20207251</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject><![CDATA[Adult ; Anti-Infective Agents, Local - administration & dosage ; cesarean delivery ; Cesarean Section ; Endometritis - prevention & control ; Female ; Fever - prevention & control ; Gravidity ; Humans ; Labor Stage, First ; Labor, Obstetric ; Obstetrics and Gynecology ; Parity ; Patient Readmission ; Postoperative Complications - prevention & control ; postoperative maternal morbidities ; povidone iodine ; Povidone-Iodine - administration & dosage ; Pregnancy ; Preoperative Care ; risk ; Sepsis - prevention & control ; Surgical Stapling ; Surgical Wound Infection - prevention & control ; Sutures ; Vagina - microbiology ; vaginal preparation]]></subject><ispartof>American journal of obstetrics and gynecology, 2010-03, Vol.202 (3), p.310.e1-310.e6</ispartof><rights>Mosby, Inc.</rights><rights>2010 Mosby, Inc.</rights><rights>Copyright 2010 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-6d4746bc5e199e98ff7fd79f164668457f7d42bcc9e8d0a6d649a191131933973</citedby><cites>FETCH-LOGICAL-c410t-6d4746bc5e199e98ff7fd79f164668457f7d42bcc9e8d0a6d649a191131933973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937810000062$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20207251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haas, David M., MD, MS</creatorcontrib><creatorcontrib>Pazouki, Fatemeh, MD</creatorcontrib><creatorcontrib>Smith, Ronda R</creatorcontrib><creatorcontrib>Fry, Amy M., MD</creatorcontrib><creatorcontrib>Podzielinski, Iwona, MD</creatorcontrib><creatorcontrib>Al-Darei, Sarah M., MD</creatorcontrib><creatorcontrib>Golichowski, Alan M., MD, PhD</creatorcontrib><title>Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>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.</description><subject>Adult</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>cesarean delivery</subject><subject>Cesarean Section</subject><subject>Endometritis - prevention & control</subject><subject>Female</subject><subject>Fever - prevention & control</subject><subject>Gravidity</subject><subject>Humans</subject><subject>Labor Stage, First</subject><subject>Labor, Obstetric</subject><subject>Obstetrics and Gynecology</subject><subject>Parity</subject><subject>Patient Readmission</subject><subject>Postoperative Complications - prevention & control</subject><subject>postoperative maternal morbidities</subject><subject>povidone iodine</subject><subject>Povidone-Iodine - administration & dosage</subject><subject>Pregnancy</subject><subject>Preoperative Care</subject><subject>risk</subject><subject>Sepsis - prevention & control</subject><subject>Surgical Stapling</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Sutures</subject><subject>Vagina - microbiology</subject><subject>vaginal preparation</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-P1SAUxYnROM_RL-DCsHNj31xoHxRjJjET_0wyiYtRt4TC7QuVlie0Y958emne6MKFbAiXc07gdwh5yWDLgImLYWuGuN9yKANgW4DdI7JhoGQlWtE-JhsA4JWqZXtGnuU8rEeu-FNyxoGD5Du2Ib--m72fTKA2oJmyn_a0wz4mpBazSWVGHQZ_h-lI50gTusUiPcQ8xwMmM5cb6qce7ezjkukYU-edn49vqaHJTC6O_h7dG2rjNKcYAjo6J2_Cc_KkNyHji4f9nHz7-OHr1efq5sun66v3N5VtGMyVcI1sRGd3yJRC1fa97J1UPRONEG2zk710De-sVdg6MMKJRhmmGKuZqmsl63Py-pR7SPHngnnWo88WQzATlgdrWdcShGxUUfKT0qaYc8JeH5IfTTpqBnrlrQe98tYrbw1MF97F9OohfulGdH8tfwAXwbuTAMsn7zwmna3HyaLzqUDTLvr_51_-Y7fBT96a8AOPmIe4pFJe1kxnrkHfrhWvhTNYl-D1b9vJp9s</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>Haas, David M., MD, MS</creator><creator>Pazouki, Fatemeh, MD</creator><creator>Smith, Ronda R</creator><creator>Fry, Amy M., MD</creator><creator>Podzielinski, Iwona, MD</creator><creator>Al-Darei, Sarah M., MD</creator><creator>Golichowski, Alan M., MD, PhD</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100301</creationdate><title>Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial</title><author>Haas, David M., MD, MS ; Pazouki, Fatemeh, MD ; Smith, Ronda R ; Fry, Amy M., MD ; Podzielinski, Iwona, MD ; Al-Darei, Sarah M., MD ; Golichowski, Alan M., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-6d4746bc5e199e98ff7fd79f164668457f7d42bcc9e8d0a6d649a191131933973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Anti-Infective Agents, Local - administration & dosage</topic><topic>cesarean delivery</topic><topic>Cesarean Section</topic><topic>Endometritis - prevention & control</topic><topic>Female</topic><topic>Fever - prevention & control</topic><topic>Gravidity</topic><topic>Humans</topic><topic>Labor Stage, First</topic><topic>Labor, Obstetric</topic><topic>Obstetrics and Gynecology</topic><topic>Parity</topic><topic>Patient Readmission</topic><topic>Postoperative Complications - prevention & control</topic><topic>postoperative maternal morbidities</topic><topic>povidone iodine</topic><topic>Povidone-Iodine - administration & dosage</topic><topic>Pregnancy</topic><topic>Preoperative Care</topic><topic>risk</topic><topic>Sepsis - prevention & control</topic><topic>Surgical Stapling</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Sutures</topic><topic>Vagina - microbiology</topic><topic>vaginal preparation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haas, David M., MD, MS</creatorcontrib><creatorcontrib>Pazouki, Fatemeh, MD</creatorcontrib><creatorcontrib>Smith, Ronda R</creatorcontrib><creatorcontrib>Fry, Amy M., MD</creatorcontrib><creatorcontrib>Podzielinski, Iwona, MD</creatorcontrib><creatorcontrib>Al-Darei, Sarah M., MD</creatorcontrib><creatorcontrib>Golichowski, Alan M., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haas, David M., MD, MS</au><au>Pazouki, Fatemeh, MD</au><au>Smith, Ronda R</au><au>Fry, Amy M., MD</au><au>Podzielinski, Iwona, MD</au><au>Al-Darei, Sarah M., MD</au><au>Golichowski, Alan M., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>202</volume><issue>3</issue><spage>310.e1</spage><epage>310.e6</epage><pages>310.e1-310.e6</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><abstract>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.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>20207251</pmid><doi>10.1016/j.ajog.2010.01.005</doi></addata></record> |
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| subjects | Adult Anti-Infective Agents, Local - administration & dosage cesarean delivery Cesarean Section Endometritis - prevention & control Female Fever - prevention & control Gravidity Humans Labor Stage, First Labor, Obstetric Obstetrics and Gynecology Parity Patient Readmission Postoperative Complications - prevention & control postoperative maternal morbidities povidone iodine Povidone-Iodine - administration & dosage Pregnancy Preoperative Care risk Sepsis - prevention & control Surgical Stapling Surgical Wound Infection - prevention & control Sutures Vagina - microbiology vaginal preparation |
| title | Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial |
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