Vaginal Preparation With Chlorhexidine-alcohol vs. Povidine-iodine vs. Saline

The Effect of Vaginal Preparation With Chlorhexidine-alcohol vs. Povidine-iodine vs. Saline on Vaginal Bacteria Colony Counts in Pregnant Women

The purpose of this study is to see whether chlorhexidine is superior to povidine-iodine vaginal antisepsis at reducing bacteria colony counts in pregnant women by comparing three groups: vaginal washing with chlorhexidine-alcohol, vaginal washing with povidine-iodine, and vaginal washing with saline alone.

This is a prospective trial of vaginal preparation (or vaginal cleansing/washing) on late preterm and term pregnancies admitted to Labor & Delivery unit for cesarean delivery with three arms. Randomization allocation would be performed in 1:1:1 fashion for vaginal preparation with chlorhexidine-alcohol, povidine-iodine, and saline washes. A saline wash group is included to determine if the act of cleansing the vagina with a sponge alone reduces bacterial colony counts.

Intervention Group (vaginal preparation)

Inclusion Criteria:

• Pregnant women admitted for cesarean delivery
• Gestational age greater than or equal to 34 weeks

Exclusion Criteria:

• Rupture of membranes or active labor
• Chorioamnionitis (prior to enrollment)
• Recent (within 4 weeks) antibiotic exposure
• Maternal HIV infection or immunocompromised state
• Known allergy to shellfish, iodine, or chlorhexidine