Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine

Leonardo Pereira, Tsungai Chipato, Alexio Mashu, Velda Mushangwe, Simbarashe Rusakaniko, Shrikant I. Bangdiwala, Office Samson Chidede, Gary L. Darmstadt, Lovemore Gwanzura, Gwendoline Kandawasvika, Simon Madzime, Pisake Lumbiganon, Jorge E. Tolosa

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)234-238
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Volume112
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Chlorhexidine
  • Neonatal sepsis
  • Vaginal washing

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Pereira, L., Chipato, T., Mashu, A., Mushangwe, V., Rusakaniko, S., Bangdiwala, S. I., Chidede, O. S., Darmstadt, G. L., Gwanzura, L., Kandawasvika, G., Madzime, S., Lumbiganon, P., & Tolosa, J. E. (2011). Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine. International Journal of Gynecology and Obstetrics, 112(3), 234-238. https://doi.org/10.1016/j.ijgo.2010.09.009