Vaginal Preparation and Azithromycin to Reduce Post Cesarean Infections

Combining Vaginal Preparation and Azithromycin in Reduction of Post Cesarean Infections: A Randomized Controlled Trial

Infection, Obstetric Labor Complications, Endometritis, Cesarean Delivery Affecting Fetus, Wounds Injuries

In addition to standard care, subjects will undergo vaginal preparation (VP). A VP kit includes sponge sticks and sponges soaked in a povidone-iodine 10% solution.

The very staff will follow hospital protocols for the cesarean delivery. The subject and the infant will be provided care in accordance with current medical standards and be discharged at the discretion of the attending physician.

One sponge stick will be inserted into the vagina, where it will stay during the scrubbing of thighs and genitals. One sponge will be used to scrub the right inner thigh from mid-thigh to right labia majora. This sponge will then be discarded. A second sponge will be used to scrub the left inner thigh from mid-thigh to left labia majora. This sponge will then be discarded. A third sponge will be used to scrub the mons pubs, labia majora and minor, perineum and rectum in that order then will be discarded. This will be repeated with a fourth sponge. The existing sponge stick in the vagina will be rotated in the vagina twice then removed. This will be discarded. A second sponge stick will be inserted in the vagina, rotated twice then removed. As it is removed from the vagina, the perineum and rectum will be swabbed with the stick in that order then discarded. This will be repeated using a third sponge stick.

Pregnant females admitted to Womack Army Medical Center who deliver full term via unscheduled, non-emergent cesarean section following labor

Inclusion Criteria: full term pregnancy undergoing labored, non-emergent cesarean section patient in labor Exclusion Criteria: Azithromycin contraindicated: Known hypersensitivity to azithromycin, erythromycin, macrolides or ketolide medications. liver dysfunction Prescription medications which may interact with azithromycin, such as nelfinavir or warfarin A history of a cardiac dysrhythmia (irregular heartbeats) Known hypersensitivity to iodine Patients carrying fetuses with known congenital anomalies Immunodeficiency Patients who are not in labor at the time of delivery Non-english speaking subjects or subjects with language barriers

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