What is the result of vaginal cleansing with chlorhexidine during labour on maternal and neonatal infections? A systematic review of randomised trials with meta-analysis

BMC Pregnancy and Childbirth

Amie Wilson¹  David Lissauer²  Vin Ramkhelawon³  Trevor Akister³  Charlotte Bell⁴  Laura Hughes⁵ 

[1] Institute of Applied Health Research, University of Birmingham;Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham;Sandwell and West Birmingham Hospitals NHS Trust;South Warwickshire NHS Foundation Trust;Wye Valley NHS Trust, The County Hospital;

关键词: Maternal;    Chlorhexidine;    Infection;    Systematic review;    Neonatal;    Infection prevention;   

DOI  :  10.1186/s12884-018-1754-9

来源: DOAJ

【 摘 要 】

Abstract Background Infection with vaginal microorganisms during labour can lead to maternal and neonatal mortality and morbidity. The objective of this systematic review is to review the effectiveness of intrapartum vaginal chlorhexidine in the reduction of maternal and neonatal colonisation and infectious morbidity. Methods Search strategy – Eight databases were searched for articles published in any language from inception to October 2016. Selection criteria – Randomised controlled trials were included. Data Collection and analysis - Publications were assessed for inclusion. Data were extracted and assessed for risk of bias. Relative risks from individual studies were pooled using a random effects model and the heterogeneity of treatment was evaluated using Chi2 and I 2 tests. Results Eleven randomised controlled trials (n = 20,101) evaluated intrapartum vaginal chlorhexidine interventions. Meta-analysis found no significant differences between the intervention and control groups for any of the four outcomes: maternal or neonatal colonization or infection. The preferred method for chlorhexidine administration was vaginal irrigation. Conclusions Meta-analysis did not demonstrate improved maternal or neonatal outcomes with intrapartum vaginal chlorhexidine cleansing, however this may be due to the limitations of the available studies. A larger, multicentre randomised controlled trial, powered to accurately evaluate the effect of intrapartum vaginal chlorhexidine cleansing on neonatal outcomes may still be informative; the technique of douching may be the most promising.

【 授权许可】

Unknown