Does Preoperative Vaginal Preparation With Povidone-iodine Before Cesarean Delivery Reduce the Risk of Endometritis?

NCT ID: NCT01437228

Last Updated: 2011-11-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

668 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-10-31

Study Completion Date

2011-04-30

Brief Summary

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Cesarean delivery rates are increasing in Turkey and a major component of this increase is cesarean on demand. Although data on the rate of cesarean delivery in Turkey is limited, a national study reported a rate of 23.8%. Infectious morbidity, consisting primarily of endomyometritis and wound infection, remains a leading cause of postoperative complications. Estimates of postcesarean infection rates range from 7% to 20%, depending on demographic and obstetric variables. Infection following cesarean delivery results in not only increased hospital stay but also increases the cost of care. Strategies to minimize postoperative infectious and other morbidities have included modifications of surgical technique, changing of gloves, methods of placental delivery, cervical dilatation during cesarean delivery, and altering the uterine position during repair of the uterine incision. Despite these interventions, endometritis is still major problem after cesarean delivery.

Endometritis appears to result from ascending vaginal flora bacteria, with anaerobes playing an important role. The microbes endogenous to the vagina change throughout the course of pregnancy and parturition. Larsen and Galask noted that anaerobic species located in the vagina increase dramatically by the third postpartum day. In many cases, the surgeon's hand, reaching below the infant's head or presenting part, is in direct contact with the vagina. Vaginal bacterial flora have been cultured from the delivering surgeon's glove in 79% (95% confidence interval \[CI\] 58%, 100%) of cesareans that follow labor. In these cases, vaginal flora are delivered directly to the uterus, abdominal cavity, and the abdominal incision. Vaginal preparation has been shown to decrease the quantitative load of vaginal microorganisms as well as to remove certain species of bacteria.

Detailed Description

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Conditions

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Postpartum Endometritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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povidone iodine

30-second vaginal scrub with povidone- iodine solution.

Group Type OTHER

povidone- iodine solution.

Intervention Type DRUG

%10 Polivinilpirolidon iyot (Polividon- iyot

CONTROL

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

NO İNTERVENTİON

Interventions

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povidone- iodine solution.

%10 Polivinilpirolidon iyot (Polividon- iyot

Intervention Type DRUG

placebo

NO İNTERVENTİON

Intervention Type DRUG

Other Intervention Names

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BATTICON Solüsyon. Adeka NO İNTERVENTİON

Eligibility Criteria

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Inclusion Criteria

* Women older than 38 weeks estimated gestational age and required cesarean section.

Exclusion Criteria

* Highly emergent cesarean
* Allergy to povidone iodine
* Chorioamnionitis on admission
* Fever on admission
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Erzincan Military Hospital

OTHER

Sponsor Role lead

Responsible Party

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Kemal GUNGORDUK

Mardin Women and Children Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sisli Etfal Hospital

Istanbul, Sisli, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Haas DM, Morgan S, Contreras K, Kimball S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev. 2020 Apr 26;4(4):CD007892. doi: 10.1002/14651858.CD007892.pub7.

Reference Type DERIVED
PMID: 32335895 (View on PubMed)

Other Identifiers

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gungorduk13

Identifier Type: -

Identifier Source: org_study_id