What is the role of vaginal chlorhexidine douching in the prevention of endometritis?

Updated: Apr 25, 2019
  • Author: Michel E Rivlin, MD; Chief Editor: Michel E Rivlin, MD  more...
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A Cochrane database systematic review concluded that the use of vaginal chlorhexidine douching during labor does not prevent endometritis. [30] Preoperative use of povidone-iodine vaginal preparation prior to cesarean delivery appears to decrease the incidence of postcesarean endometritis but does not seem to decrease the overall risk of postoperative fever or wound infection.

A systematic review and meta-analysis by Caissutti et al reported that compared to the control group, vaginal cleansing (most commonly with 10% povidone-iodine) before cesarean delivery significantly lowered the incidence of endometritis (4.5% vs 8.8%; RR 0.52, 95% CI 0.37-0.72; 15 studies, 4,726 participants) and also lowered the risk of postoperative fever (9.4% vs 14.9%; RR 0.65, 95% CI 0.50-0.86; 11 studies, 4,098 participants). [31]

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