Context: The morbidity and mortality rates associated with post-cesarean section (CS) infectious
complications prove to be a burden for mothers, their infants, and the healthcare system. Aim: This
study aimed to assess the effect of pre-elective cesarean section vaginal cleansing using povidone
iodine versus chlorhexidine on the incidence of post-cesarean infections. Methods: This
randomized controlled trial involved a simple random sample of 90 women undergoing elective CS
who were allocated to either the control, povidone-iodine, or chlorhexidine group. The study was
conducted at the Obstetrics and Gynecology Operative Department of Kafrelsheikh University
Hospital, Kafrelsheikh Governorate, Egypt. Data were collected using two tools: Structured
interview schedule and post-CS infection checklist. Results: The povidone-iodine group had a
significantly lower rate of post-CS fever, endometritis, and wound infection than the control group
(p = 0.045, 0.049, and 0.045, respectively). Furthermore, the control group had a significantly
higher rate of post-CS fever, endometritis, and wound infection than the chlorhexidine group (p =
0.011, 0.028, and 0.031, respectively). In contrast, no statistically significant difference was
observed in the rate of post-CS fever, endometritis, and wound infection between the povidone
iodine and chlorhexidine groups (p = 0.300, 0.128, and 0.447, respectively). Conclusion: Vaginal
cleansing using either povidone-iodine or chlorhexidine immediately before elective CS
significantly reduces the rate of post-cesarean infections. Recommendation: This simple and cost
effective vaginal cleansing method should be applied by nurses before elective CS.