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Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine
Author(s) -
Pereira Leonardo,
Chipato Tsungai,
Mashu Alexio,
Mushangwe Velda,
Rusakaniko Simbarashe,
Bangdiwala Shrikant I.,
Chidede Office Samson,
Darmstadt Gary L.,
Gwanzura Lovemore,
Kandawasvika Gwendoline,
Madzime Simon,
Lumbiga Pisake,
Tolosa Jorge E.
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.09.009
Subject(s) - medicine , chlorhexidine , randomized controlled trial , incidence (geometry) , rash , obstetrics , vagina , pregnancy , adverse effect , surgery , dentistry , physics , optics , biology , genetics
Objective To determine the safety, acceptability, and antimicrobial effect of 1% chlorhexidine (CHX) vaginal washing of women in labor and their neonates. Methods Randomized controlled trial of 1% CHX vaginal and neonatal washing compared with no washing (usual care [UC]). The study included 502 women (334 CHX, 168 UC) who delivered 508 liveborn neonates (335 CHX, 173 UC). Main outcome measures were the incidence of maternal adverse effects, the incidence of neonatal skin rash, the axillary temparature before and after neonatal wiping, and vaginal culture results. Results Maternal demographics did not differ between the groups. No case of maternal rash occured; 4% of women experienced vaginal burning. An axillary temperature drop of more than 1 °C after CHX cleansing occurred in 8 neonates; 2 neonates had a minor rash. In the subset of women with positive vaginal cultures as baseline, 1% CHX eliminated culture growth in 56% after 1 wash, and in 86% after 2 washes. Conclusions Use of 1% CHX is safe for neonates, well tolerated by laboring mothers, and effective in treating vaginal infections during labor. A randomized controlled trial using 1% CHX and powered for a reduction in neonatal septic mortality is justified based on these data.