Study on the usefulness of povidone-iodine obstetric cream with special reference to the effect on the thyroid functions of mothers and the newborn.

The effect of povidone-iodine obstetric cream (OAD cream) on the thyroid functions of mothers and the newborn was investigated in 56 patients. Effects on labour and on the neonatal course of the newborn were also studied. OAD cream was used for disinfection of the vulva and vagina during prenatal obstetric examinations (1-10 times) and at parturition. Bacteriological specimens were obtained before and after use of the OAD cream, and the total iodine, thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels were measured in the maternal blood and umbilical cord blood. The overall bacterial eradication rate for the vulva was 74.7% although the eradication rate for coagulase negative staphylococci was low (23.1%). The overall bacterial eradication rate for the vagina was 56.1% although the eradication rates for Candida albicans and Lactobacillus spp. were low (9.1% and 29.4% respectively). There was no significant difference in the types of delivery or complications of labour and delivery between the group treated with OAD cream and the control group, but the duration of labour was prolonged in the former group. There were no malformations among the newborn, and no difference between the group treated with OAD cream and the control group in regard to body weight and length of the newborn at birth, Apgar score, postnatal gain in body weight, or bilirubin level. The maternal blood levels of total iodine, TSH, and T4 were within the normal ranges both during pregnancy and at delivery, but the level of T3 was slightly elevated at delivery. The umbilical cord blood levels of the total iodine, TSH, and T4 were within normal ranges both during pregnancy and at delivery, but the level of T3 was somewhat elevated. At age six days, the T4 level was normal in all the newborn. TSH was higher than 15 microU/ml in two newborns, but returned to normal levels three week later.