Sage Journals: Discover world-class research

Abstract

Despite the use of prophylactic antibiotics during Caesarean delivery, post-Caesarean surgical site infection (SSI) and endometritis still often complicate the puerperal period. We speculated that the use of vaginal cleansing with chlorhexidine solution would serve as an adjunct to prophylactic antibiotics in reducing the menace of post-caesarean endometritis and indeed found a significant reduction.

Keywords

disease prevention disease Africa location pregnancy physiology birth surgery

Get full access to this article

View all access options for this article.

References

Williams

Pastorek

. Postpartum endomyometritis. Infect. Dis. in Obstet. Gynaecol 1995; 3: 210–216.

Novy MJ, Eschenbach DA and Witkin SS. Infections as a cause of Infertility. Available at https://www.glowm.com/womens-medicine-amp.html?item=327&name=infections-as-a-cause-of-infertility. Last accessed 20/05/2017.

Say

Chou

Gemill

, et al. Global causes of maternal deaths; a WHO systematic analysis. Lancet Glob. Health 2014; 2: e323–e333.

Van Dillen

Zwart

Van Roosmalen

. Maternal sepsis: epidemiology, aetiology and outcome. Curr. Opin. Infect. Dis 2010; 23: 249. PubMed −54.

Eschenbach

Wager

. Puerperal infection. Clin. Obstet. Gynecol 1980; 23: 1003–1037.

Betran

Moller

, et al. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS ONE 2016; 11: 1–12.

Naidoo

Mooley

. Rising rates of cesarean section: an audit of caesarean section in a specialist private practice. SA Fam. Pract 2009; 51: 254–258.

Ugwu

EOV

Obioha

KCE

Okezie

, et al. A five-year survey of caesarean delivery at a Nigerian tertiary hospital. Ann. Med. and Health Sci. Res 2011; 1: 77–84.

Report of a Technical Working Group World Health Organization (WHO). The prevention and management of puerperal infections; definition of puerperal sepsis. WHO/FHE/MSM/95.5. 1992.

10.

Ngai

Van Arsdale

Govindappagari

. Skin preparation for prevention of surgical site infection after cesarean delivery: a randomized controlled trial. Obstet. Gynaecol 2015; 126: 1251–1257.

11.

Rehu

Nilsson

. Risk factors for febrile morbidity associated with caesarean section. Obstet. Gynaecol 1980; 56: 269–273.

12.

WHO. Antimicrobial Resistance Global Report on Surveillance 2014. Available at www.who.int/drugsresistance/documents/surveillancereport/en.

13.

Haas

Morgan

Contreras

. Vaginal preparation with antiseptic solution before caesarean section for preventing postoperative infections. Cochrane Database Sys. Rev 2014; 12: 2316–2232.

14.

Tewfik

Ibrahim

Hanafi

, et al. Pre-operative vaginal preparation using povidone-iodine versus chlorhexidine solution in prevention of endometritis in elective caesarean section. Int. J Curr. Microbiol. and Appl. Sc 2015; 4: 486–492.

15.

Rouse

Hauth

Andrews

, et al. Chlorhexidine vaginal irrigation for prevention of peripartal infection: a placebo-controlled trial. A J Obstet. Gynaecol 1997; 176: 617–622.

16.

Ahmed

Aref

Sayed Ahmed

, et al. Chlorhexidine vaginal wipes prior to elective caesarean section: does it reduce infection morbidity? A randomized trial. J Mat-Fet. Neonatal Med 2016; 30: 1484–1487.

17.

Emilson

. Susceptibility of various micro-organisms to chlorhexidine. Scan. J Dent. Res 1977; 85: 255–265. PubMed PubMed.

18.

Mamgram

Horan

Pearson

. Guideline for prevention of surgical site infection 1999. Centers for disease prevention and control (CDC) hospital infection control practices advisors committee. Am. J Infect. Control 1999; 27: 97–132.

19.

Onwuasoigwe

. Determination of Sample Size in Medical Research project: A practical guide 2004: 111-8.

20.

Research Randomizer. Generate random numbers. Available at https://www.randomizer.org/. Last accessed 15/10/2020.

21.

Burman

Christensen

Frukund

, et al. Prevention of excess neonatal morbidity associated with GBS by vaginal chlorhexidine disinfection during labour. Lancet 1992; 340: 65–69. PubMed PubMed.

22.

Dehbashi

Honarvar

Fardi

. Manual removal or spontaneous placental delivery and post caesarean endometritis and bleeding. Int. J Gynaecol. Obstet 2004; 86: 12. PubMed −5.

23.

Anorlu

Maholwana

Hofmeyr

. Methods of delivering the placenta at caesarean section. Cochrane Database Syst Rev 2010; 3: CD004737.

24.

Gilstrap

Cunningham

. The bacterial pathogenesis of infection following caesarean section. Obstet. Gynecol 1979; 53: 545–549.

25.

Olsen

Butler

Willers

, et al. Risk factors for endometritis following low transverse caesarean section. Infect. Control Hosp. Epidemiol 2010; 31: 69. PubMed −77.

26.

Tita

Hauth

Grimmes

, et al. Decreasing incidence of endometritis with extended spectrum antibiotics prophylaxis. Int. J Obstet. Gynaecol 2008; 111: 51. PubMed −55.

27.

Alabi

Adebayo

Awonuga

, et al. Dissertation Repository, National Postgraduate Medical College of Nigeria. Available at www.dissertation.npmcn.edu.ng/index.php/FMCOG/article/view/1859. Last accessed 18/06/19.

28.

Marzouk

Emarah

Zaitoun

. Effect of preoperative vaginal cleansing using chlorhexidine antiseptic on post-caesarean section infectious morbidity. Clin. Nursing Studies 2019; 7: 107–114.

29.

Taha

Robert

Robin

, et al. Effects of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi. Clin. Trial, BMJ 1997; 315: 216–219.

30.

Bakr

Karkour

. Effects of predelivery vaginal antisepsis on maternal and neonatal morbidity and mortality in Egypt. J Women’s Health 2005; 14: 496–501.

Effectiveness of Chlorhexidine vaginal cleansing in reducing post-caesarean endometritis at two tertiary hospitals in Enugu,Nigeria: A randomized controlled trial

Abstract

Keywords

Get full access to this article

References