{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:58:47Z","timestamp":1793825927725,"version":"4.6.1"},"reference-count":53,"publisher":"Elsevier BV","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007219","name":"Natural Science Foundation of Shanghai","doi-asserted-by":"publisher","award":["2020JM-337"],"award-info":[{"award-number":["2020JM-337"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajogmfm.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Obstetrics &amp; Gynecology MFM"],"published-print":{"date-parts":[[2023,8]]},"DOI":"10.1016\/j.ajogmf.2023.100990","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T02:39:43Z","timestamp":1683772783000},"page":"100990","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Different methods of vaginal preparation before cesarean delivery to prevent postoperative infection: a systematic review and network meta-analysis"],"prefix":"10.1016","volume":"5","author":[{"given":"Guan","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangliang","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Dou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junru","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangdong","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-5488","authenticated-orcid":false,"given":"Xilin","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajogmf.2023.100990_bib0001","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-005671","article-title":"Trends and projections of caesarean section rates: global and regional estimates","volume":"6","author":"Betran","year":"2021","journal-title":"BMJ Glob Health"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0002","doi-asserted-by":"crossref","first-page":"455.e1","DOI":"10.1016\/j.ajog.2007.03.022","article-title":"Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial","volume":"196","author":"Sullivan","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0003","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1067\/mob.2001.111303","article-title":"Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: a meta-analysis","volume":"184","author":"Chelmow","year":"2001","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0004","doi-asserted-by":"crossref","first-page":"416.e1","DOI":"10.1016\/j.ajog.2018.01.016","article-title":"Applying surgical antimicrobial standards in cesarean deliveries","volume":"218","author":"Fay","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002494","article-title":"Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis","volume":"15","author":"Keag","year":"2018","journal-title":"PLoS Med"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0006","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/S0140-6736(18)31930-5","article-title":"Short-term and long-term effects of caesarean section on the health of women and children","volume":"392","author":"Sandall","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0007","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1016\/S0140-6736(18)32386-9","article-title":"Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis","volume":"393","author":"Sobhy","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0008","article-title":"Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section","volume":"2014","author":"Smaill","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0009","article-title":"Antibiotic regimens for postpartum endometritis","volume":"2015","author":"Mackeen","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0010","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/00006250-199102000-00026","article-title":"Upper genital tract isolates at delivery as predictors of post-cesarean infections among women receiving antibiotic prophylaxis","volume":"77","author":"Watts","year":"1991","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0011","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/S0002-9378(16)32326-2","article-title":"Vaginal colonization with resistant aerobic bacteria after antibiotic therapy for endometritis","volume":"142","author":"Gibbs","year":"1982","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0012","first-page":"115","article-title":"Single-dose ampicillin prophylaxis does not eradicate enterococcus from the lower genital tract","volume":"81","author":"Graham","year":"1993","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0013","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/0002-9378(84)90109-1","article-title":"Comparative cervical microflora shifts after cefoxitin or cefazolin prophylaxis against infection following cesarean section","volume":"149","author":"Stiver","year":"1984","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0014","article-title":"Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections","volume":"7","author":"Haas","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0015","article-title":"Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections","volume":"4","author":"Haas","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0016","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2019.04.002","article-title":"Povidone-iodine 1% is the most effective vaginal antiseptic for preventing post-cesarean endometritis: a systematic review and network meta-analysis","volume":"221","author":"Roeckner","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0017","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/AOG.0000000000002167","article-title":"Vaginal cleansing before Cesarean delivery: a systematic review and meta-analysis","volume":"130","author":"Caissutti","year":"2017","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0018","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/01.AOG.0000433982.36184.95","article-title":"American College of Obstetricians and Gynecologists Women's Health Care Physicians, Committee on Gynecologic Practice. Committee Opinion No. 571: solutions for surgical preparation of the vagina","volume":"122","year":"2013","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0019","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0020","doi-asserted-by":"crossref","first-page":"777","DOI":"10.7326\/M14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0021","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0022","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2307\/3001666","article-title":"The combination of estimates from different experiments","volume":"10","author":"Cochran","year":"1954","journal-title":"Biometrics"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0023","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0024","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0025","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/jrsm.1045","article-title":"Consistency and inconsistency in network meta-analysis: model estimation using multivariate meta-regression","volume":"3","author":"White","year":"2012","journal-title":"Res Synth Methods"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0026","doi-asserted-by":"crossref","first-page":"e76654","DOI":"10.1371\/journal.pone.0076654","article-title":"Graphical tools for network meta-analysis in Stata","volume":"8","author":"Chaimani","year":"2013","journal-title":"PLoS One"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0027","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jclinepi.2010.03.016","article-title":"Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial","volume":"64","author":"Salanti","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0028","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1080\/14767058.2016.1219996","article-title":"Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial","volume":"30","author":"Ahmed","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0029","first-page":"260","article-title":"Influence of pre-operative vaginal cleansing with povidone iodine on postcesarean infection","volume":"11","author":"Alobaidy","year":"2020","journal-title":"J Cardiovasc Dis Res"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0030","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jogoh.2018.11.002","article-title":"Vaginal cleansing prior to caesarian section: to do or not to do?: a randomized trial","volume":"48","author":"Aref","year":"2019","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0031","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3109\/01443615.2011.568644","article-title":"Preoperative vaginal preparation with povidone-iodine on post-caesarean infectious morbidity","volume":"31","author":"Asghania","year":"2011","journal-title":"J Obstet Gynaecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0032","doi-asserted-by":"crossref","DOI":"10.1016\/j.jogoh.2020.101981","article-title":"The effect of vaginal disinfection on reducing post-caesarean endometritis: a prospective, randomised controlled trial","volume":"50","author":"Ba\u011fl\u0131","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0033","first-page":"2","article-title":"Impact of preoperative vaginal preparation with povidone iodine on post cesarean infection","volume":"2","author":"Barat","year":"2016","journal-title":"Caspian-J-Repord-Med"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0034","first-page":"117","article-title":"Preoperative vaginal painting with 1% povidone-iodine before cesarean delivery to reduce postoperative febrile morbidity: a randomized control trial","volume":"30","author":"Charoenviboonphan","year":"2011","journal-title":"Region 4-5 Med J"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0035","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2010.01.005","article-title":"Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial","volume":"202","author":"Haas","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0036","first-page":"142","article-title":"Effect of prophylactic preoperative nursing interventions on prevention of endometritis among women undergoing elective caesarean delivery","volume":"6","author":"Khedr","year":"2016","journal-title":"J Nurs Educ Pract"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0037","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/aogs.13737","article-title":"Vaginal preparation with chlorhexidine at cesarean section to reduce endometritis and prevent sepsis: a randomized pilot trial (PREPS)","volume":"99","author":"Hodgetts-Morton","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0038","first-page":"823","article-title":"Vaginal Prepration with povidone-iodine solution before Cesarean section for preventing postpartum endometritis: a randomized clinical trial","volume":"29","author":"Jinzhi Li","year":"2013","journal-title":"J Pract Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0039","first-page":"4895","article-title":"Preventive effect of povidone-iodine disinfection of vagina before cesarean section on postpartum endometritis and abdominal incision infection","volume":"30","author":"Shang","year":"2014","journal-title":"Matern Child Health Care China"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0040","first-page":"2595","article-title":"Effect of vaginal disinfection with drugs on endometritis and surgical site infection in puerpera undergoing cesarean section","volume":"11","author":"Jirong Xie","year":"2017","journal-title":"Chin J Nosocomiology"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0041","doi-asserted-by":"crossref","first-page":"33","DOI":"10.5472\/marumj.866504","article-title":"The effect of vaginal cleansing performed with normal saline solution or povidone-iodine before elective caesarean section on postoperative maternal morbidity and infection: a prospective randomized controlled study","volume":"1","author":"Kanza","year":"2021","journal-title":"Marmara Med J"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0042","first-page":"95","article-title":"Vaginal cleansing prior to cesarean section and post-operative infectious morbidity","volume":"8","author":"Kiani","year":"2018","journal-title":"J Soc Obstet Gynaecol Pak"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0043","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ajogmf.2019.03.004","article-title":"Vaginal cleansing with chlorhexidine gluconate or povidone-iodine prior to cesarean delivery: a randomized comparator-controlled trial","volume":"1","author":"Lakhi","year":"2019","journal-title":"Am J Obstet Gynecol MFM"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0044","first-page":"1179","article-title":"Effect of preoperative vaginal cleansing with an antiseptic solution to reduce post caesarean infectious morbidity","volume":"61","author":"Memon","year":"2011","journal-title":"J Pak Med Assoc"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0045","series-title":"Effects of preoperative vaginal cleansing with povidone iodine on post-cesarean maternal infections at Kenyatta national hospital: a randomized, controlled trial","author":"Mwangi","year":"2013"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0046","first-page":"4310","article-title":"Antiseptic vaginal preparation before cesarean ajog.org OBSTETRICS Original Research delivery to reduce post operative infection: a randomised controlled trial","volume":"3","author":"Nandi","year":"2015","journal-title":"J Med Sci Clin Res"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0047","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/aogs.14060","article-title":"Preoperative vaginal cleansing with chlorhexidine solution in preventing post-cesarean section infections in a low resource setting: a randomized controlled trial","volume":"100","author":"Ogah","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0048","first-page":"81","article-title":"Does vaginal preparation with povidoneiodine prior to cesarean delivery reduce the risk of endometritis","volume":"5","author":"Olmez","year":"2013","journal-title":"Jinekoloji Obstet Pediatri ve Pediatr Cerrahi Derg"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0049","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1097\/01.AOG.0000164032.16599.7e","article-title":"Preoperative vaginal preparation with povidone-iodine and the risk of postcesarean endometritis","volume":"105","author":"Starr","year":"2005","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0050","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.3109\/14767058.2012.693994","article-title":"Does vaginal preparation with povidone-iodine prior to caesarean delivery reduce the risk of endometritis? A randomized controlled trial","volume":"25","author":"Yildirim","year":"2012","journal-title":"J Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0051","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2014.03.040","article-title":"Infectious morbidity is higher after second-stage compared with first-stage cesareans","volume":"211","author":"Tuuli","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0052","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2017.05.070","article-title":"Impact of evidence-based interventions on wound complications after cesarean delivery","volume":"217","author":"Temming","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2023.100990_bib0053","series-title":"WHO recommendation on vaginal preparation with antiseptic agents for women undergoing caesarean section","year":"2021"}],"container-title":["American Journal of Obstetrics &amp; Gynecology MFM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589933323001325?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589933323001325?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:30:17Z","timestamp":1793122217000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589933323001325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":53,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["S2589933323001325"],"URL":"https:\/\/doi.org\/10.1016\/j.ajogmf.2023.100990","relation":{},"ISSN":["2589-9333"],"issn-type":[{"value":"2589-9333","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Different methods of vaginal preparation before cesarean delivery to prevent postoperative infection: a systematic review and network meta-analysis","name":"articletitle","label":"Article Title"},{"value":"American Journal of Obstetrics & Gynecology MFM","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajogmf.2023.100990","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"100990"}}