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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

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

Authors: Charlotte Bell, Laura Hughes, Trevor Akister, Vin Ramkhelawon, Amie Wilson, David Lissauer

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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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 I2 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.
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Metadata
Title
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
Authors
Charlotte Bell
Laura Hughes
Trevor Akister
Vin Ramkhelawon
Amie Wilson
David Lissauer
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1754-9

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