Vaginal chlorhexidine during labour for preventing maternal and neonatal infections

Vaginal chlorhexidine during labour appears not to be effective in preventing maternal and neonatal infections.

A Cochrane review included three studies on chlorhexidine vaginal douching during labour for reducing infections (excluding group B streptococcal and HIV), with a total of 3012 subjects. There was no evidence of an effect of vaginal chlorhexidine during labour in preventing maternal and neonatal infections. Although the data suggest a trend in reducing postpartum endometritis, the difference was not statistically significant (relative risk 0.83; 95% confidence interval 0.61 to 1.13).

Another Cochrane review (abstract , review ) included 5 studies on the effectiveness of vaginal disinfection with chlorhexidine during labour for preventing early-onset group B streptococcal infections, involving approximately 2190 infants. When all studies were combined there was a reduction in colonisation of group B streptococcus (RR 0.72, 95% CI 0.56–0.91); NNT 6 (95% CI 4–20). There was no statistically significant reduction in early-onset disease including GBS infection, GBS pneumonia, GBS meningitis or mortality.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes).

Ədəbiyyat

1. Lumbiganon P, Thinkhamrop J, Thinkhamrop B, Tolosa JE. Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV). Cochrane Database Syst Rev 2004 Oct 18;(4):CD004070 [Review content assessed as up-to-date: 30 June 2014].
2. Stade B, Shah V, Ohlsson A. Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection. Cochrane Database Syst Rev 2004;(3):CD003520 [Review content assessed as up-to-date: 31 August 2007].