Prevention of neonatal infections by vaginal chlorhexidine disinfection during labour

Henrichsen, Thore; Lindemann, Rolf; Svenningsen, Leif; Hjelle, K

doi:10.1111/j.1651-2227.1994.tb13172.x

Cited by 17 publications

(7 citation statements)

References 13 publications

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“…Consequently, the extensive vulvar cleansing during labour does not re duce the number of microorganisms, but leads to a selective transfer of maternal bacte ria, unfortunately excluding Lactobacilli. Evi dently, the idea of decontamination of the birth canal by modern antiseptics (chlorhexidine) before delivery [20] does not work properly.…”

Section: Discussionmentioning

confidence: 99%

Transmission of Mother’s Microflora to the Newborn at Birth

Mändar

Mikelsaar²

1996

Neonatology

143

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Our aim was to study the initial microbial colonization of the newborns by comparing it with their mothers’ vaginal microflora. Nineteen mother-newborn pairs were examined at delivery. We found a close association, both qualitative and quantitative, between the individually different microflora of a mother’s vagina and that of her newborn. The degree of contamination of the newborn significantly correlated with the counts of microorganisms found in the vagina of mothers. In 85% of investigated individual mother-newborn pairs we revealed similar predominant microorganisms. There were no cases of the mothers and their newborns harbouring similar potentially pathogenic prevailing microorganisms.

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Section: Discussionmentioning

confidence: 99%

Transmission of Mother’s Microflora to the Newborn at Birth

Mändar

Mikelsaar²

1996

Neonatology

143

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“…This agent has been used successfully in developed countries for prophylaxis against newborn colonization and infection with group B streptococcus. [420][421][422][423][424][425][426] community-based evidence. A study of the impact of chlorhexidine cleansing was undertaken in Malawi at an urban hospital, at a cost of $0.10 for each maternal-infant pair treated (Table 25).…”

Section: )mentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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“…Perhaps, a 10-fold dilution of the stock solution (4%) is not an effective antimicrobial strength. 12 On the other hand, Christensen's group 2 described a complex, vigorous, extensive washing procedure of the cervix, vagina, and external genital. Furthermore, the concentration used in our study was somewhat higher than what has been used in other clinical studies.…”

Section: Discussionmentioning

confidence: 99%

Chlorhexidine vs. sterile vaginal wash during labor to prevent neonatal infection

Eriksen

Sweeten

Blanco

1997

Infect. Dis. Obstet. Gynecol.

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Objective The purpose of this study was to determine if a dilute solution of chlorhexidine used as a one‐time vaginal wash intrapartum can reduce the use of postnatal antibiotics and neonatal infection. Methods Term pregnant women in labor were prospectively randomized to receive either 20 cc of 0.4% chlorhexidine (n = 481) or 20 cc of sterile water (n = 466) placebo. Exclusion criteria included fetal distress, clinical infection, cervical dilatation >6 cm, and known allergy to chlorhexidine. Outcome variables included the incidence of neonatal pneumonia, culture proven neonatal sepsis, and use of the antibiotics in the neonate. Continuous variables were compared using the Mann‐Whitney U‐test and discrete variables were compared with the chi‐square test. Results The length of ruptured membranes (mean ± S.D.) between the chlorhexidine group (408 ± 589 min) and control group (352 ± 318 min) was not significantly different (P = 0.85, 95% confidence interval 354–462). Fifteen neonates (3.2%) in the chlorhexidine group and 9 (1.9%) in the control group received antibiotics in the postnatal period (P = 0.32, 95% confidence interval 0.72–3.72). There was one case of pneumonia in the control group and no cases of sepsis in either group. Conclusions A one‐time chlorhexidine vaginal wash does not decrease the use of antibiotics or incidence of neonatal infection in our population. Infect. Dis. Obstet. Gynecol. 5:286–290, 1997. © 1998 Wiley‐Liss, Inc.

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Prevention of neonatal infections by vaginal chlorhexidine disinfection during labour

Cited by 17 publications

References 13 publications

Transmission of Mother’s Microflora to the Newborn at Birth

Transmission of Mother’s Microflora to the Newborn at Birth

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Chlorhexidine vs. sterile vaginal wash during labor to prevent neonatal infection

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