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

Bell, Charlotte, Hughes, Laura, Akister, Trevor, Ramkhelawon, Vin, Wilson, Amie and Lissauer, David ORCID: 0000-0002-7878-2327 (2018) 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, 18 (1). 139-.

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Official URL: http://dx.doi.org/10.1186/s12884-018-1754-9

Abstract

<h4>Background</h4>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.<h4>Methods</h4>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 Chi<sup>2</sup> and I<sup>2</sup> tests.<h4>Results</h4>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.<h4>Conclusions</h4>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.

Item Type:	Article
Uncontrolled Keywords:	Maternal, Chlorhexidine, Infection, Systematic review, Neonatal, Infection prevention
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	25 May 2023 11:52
Last Modified:	25 May 2023 11:52
DOI:	10.1186/s12884-018-1754-9
Open Access URL:	https://bmcpregnancychildbirth.biomedcentral.com/a...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3170689