Vaginal preparation with different antiseptic solutions before cesarean section for preventing postoperative infections: A systematic review and network meta-analysis.

AIMS: We aimed to investigate the effect of various vaginal wash solutions on reducing risks of post-cesarean endometritis, wound infections, fever, and hospital stay duration. METHODS: Scopus, Web of Science, PubMed, and Cochrane Library were searched for randomized clinical trials that compared different vaginal wash solutions to each other or to "no vaginal cleaning"; without restriction on the age of parturients or site where trials were conducted. We analyzed this frequentist network meta-analysis using the netmeta package in R software version 4.1.2; synthesized data as mean difference or risk ratio with their 95% confidence intervals. RESULTS: Our network meta-analysis included 29 RCTs with a total sample size of 9311 women undergoing CS. Regarding post-cesarean endometritis, we found that povidone-iodine had the highest significant risk reduction compared to "no vaginal cleaning" (RR = 0.08, 95% CI [0.01, 0.69]). While regarding post-cesarean reduction of wound infection, fever, and hospital stay duration, we found that chlorhexidine 4% (RR = 0.17, 95% CI [0.05, 0.65]), saline 0.9% (RR = 0.12, 95% CI [0.03; 0.48]), and saline 0.9% (MD = -1.29, 95% CI [-2.18; -0.39]), respectively, had the highest significant risk reduction compared to "no vaginal cleaning." CONCLUSION: Vaginal wash solutions were associated with a significant reduction of post-cesarean endometritis, wound infection, fever, and hospital stay duration. Since povidone-iodine had the highest significant reduction of post-cesarean endometritis, we recommend setting povidone-iodine as the standard practice as pre cesarean vaginal wash solution; consistent practice guidelines of Enhanced Recovery After Surgery (ERAS).

A review of the main placenta histopathological findings reported in coronavirus disease 2019.

Several studies have reported that pregnant women are more susceptible to contracting the SARS-CoV-2 disease. However, SARS-CoV-2 infection studies have limited evidence regarding its impact on pregnancy, particularly its pathological effects on the maternal-fetal interface. This review emphasized the placental structures and immunomodulatory defense mechanism against the viral infection COVID and highlighted the spectrum of reported histopathological changes from SARS-CoV-2-infected mothers' placenta to contribute to the knowledge of the nature of this placental pathology. Further studies where collaborations that seek to maximize sample numbers analyzed can be performed to improve the generalizability and reliability of the findings. This can lead to improved knowledge on the relationship between placental dysfunction and pathology from maternal SARS-CoV-2 infection. Consequently, this can help improve maternity care delivery during the pandemic.

The pattern of gynecological malignancies in Al-Madinah Al-Munawarah region, Saudi Arabia: An overview of 6 years.

OBJECTIVES: To describe the frequency and spectrum of different types of gynecological malignancies (malignant tumors of the female genital tract) and to characterize the pattern of gynecological neoplasms in different age groups in Al-Madinah Al-Munawarah, Saudi Arabia. METHODS: This 6-year retrospective-design research was carried out on different age groups in Al-Madinah Al-Munawarah region, from June 2015 until June 2021. The patients' information of all 200 specimens, including age, nationality, tumor site, and pathological disorders was obtained from the Maternity and Children Hospital, Al-Madinah Al-Munawarah. RESULTS: Endometrial cancer was the most common malignancy for women of 31 years and above (69.0%). Tumors of the uterine corpus were mostly epithelial (86.7%) and possessed an endometrioid carcinoma histology (90.6%). There was only a small decline in gynecological cancer incidences in Al-Madinah Al-Munawarah over the past 6 years. CONCLUSION: Most of the cancer incidences, regardless of the pathological diagnosis, either increased or remained unchanged over time, is a possible indication of the current state of health programs and information available to the citizens in Al-Madinah Al-Munawarah. Further studies exploring the economic background of diagnosed patients may be of interest to future research.