{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:58:47Z","timestamp":1781236727768,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Infection is one of the most common causes of maternal morbidities and mortality and has been reported to be responsible for about 15% of maternal deaths. Any woman is at risk of infection during childbirth, but women undergoing cesarean section are at higher risk. Improvement in surgical procedures with asepsis and the use of antibiotics have helped reduce postoperative infectious morbidities. However, ascending infection from the lower to the upper genital tract is a common but often neglected source of infection. Cleaning the vagina with chlorhexidine antiseptic solution before cesarean section can be a cheap and affordable source of infection control. This study is aimed at evaluating the efficacy of preoperative vaginal cleansing using 1.0% chlorhexidine in the reduction of post\u2010cesarean section infectious morbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This prospective randomized control trial was conducted among 322 pregnant women who underwent an emergency cesarean section at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE\u2010FUTHA). The women were randomized into two groups. The interventional group received vaginal cleansing with three standard gauzes soaked in 30\u00a0mL 1.0% chlorhexidine gluconate solution preoperatively in addition to surgical skin cleaning with chlorhexidine\u2010alcohol. The women in the control group only had surgical skin cleaning with chlorhexidine\u2010alcohol. All the women received pre\u2010 and postoperative antibiotics. The primary outcomes were endometritis and wound infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Infectious morbidity was significantly reduced from 36.8% in the control group to 12.0% in the intervention group (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Endometritis occurred significantly less frequently in the intervention group than the control group (respectively 6.6% compared with 27.6%: relative risk [RR] 0.29, 95% confidence interval [CI] 0.16\u20100.53; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Foul\u2010smelling vaginal discharge was significantly more common in the control group than in the intervention group (11.8% vs 1.3%, respectively) but the CI was wide (RR 8.5, 95% CI 1.30\u201064.55; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Fever and wound infection were more common in the control group (5.9% vs 3.3% and 9.2% vs 5.3%) but the difference was not significant. The hospital stay was significantly shorter among the intervention group (5.54\u00a0\u00b1\u00a01.04\u00a0days compared with 6.01\u00a0\u00b1\u00a01.55\u00a0days, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05). The most common microbial isolate implicated in endocervical colonization was <jats:italic>Staphylococcus aureus<\/jats:italic> followed by <jats:italic>Klebsiella<\/jats:italic> species.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vaginal cleansing with 1.0% chlorhexidine gluconate solution before emergency cesarean section appears to be effective in reducing rates of post\u2010cesarean section infectious morbidity in the study area. We recommend its use among women undergoing cesarean section to help reduce the contribution of infections to a poor obstetrics outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14060","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T09:12:32Z","timestamp":1608714752000},"page":"694-703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Preoperative vaginal cleansing with chlorhexidine solution in preventing post\u2010cesarean section infections in a low resource setting: A randomized controlled trial"],"prefix":"10.1111","volume":"100","author":[{"given":"Christian O.","family":"Ogah","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Alex Ekwueme Federal University Teaching Hospital Abakaliki 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