Subject Area

Obstetrics and Gynecology

Document Type

Original Study



To compare the efficacy of povidone–iodine versus chlorhexidine in the prevention of postpartum endometritis and related febrile morbidity in women undergoing elective cesarean section (CS).


Use of vaginal antiseptic preparation before CS reduced the risk of postoperative endometritis, and should preoperative vaginal with antiseptics be implement before CS.

Patients and methods

A randomized comparative observational study that was conducted on 110 patients at the Gynecology and Obstetrics Department of Menoufia University Hospital. Also, they were divided into group I which included 55 women, who were subjected to preoperative vaginal preparation with povidone–iodine and group II which included 55 women who were subjected to preoperative vaginal preparation with chlorhexidine. Full history, detailed examination, and primarily samples were taken during the period study from 2019 till 2021.


There was no statistically significant difference between chlorhexidine and povidone–iodine groups regarding gestational age (P=0.67), BMI (P=0.204), systolic blood pressure (P=0.903), diastolic blood pressure (P=0.75), hypertension (P=0.982), duration of operation (P=0.061), hospital stay (P=0.85), endometritis (P=0.072), and wound infection (P=0.591). Postoperative fever was significantly increased among povidone–iodine group than the chlorhexidine group (20% vs. 2.58%, respectively, P=0.013).


Cesarean deliveries are complicated by maternal fever and wound complications including seroma, hematoma, and infection. Chlorhexidine seems to be more effective than povidone–iodine as a vaginal antiseptic preparation applied immediately before elective CS in the reduction of postpartum fever. Generally, providers should implement the simple preoperative vaginal preparation with antiseptics before cesarean deliveries.