Division of Maternal-Fetal Medicine, Oregon Health and Science University, Portland 97239, USA.
Int J Gynaecol Obstet. 2011 Mar;112(3):234-8. doi: 10.1016/j.ijgo.2010.09.009. Epub 2011 Jan 17.
To determine the safety, acceptability, and antimicrobial effect of 1% chlorhexidine (CHX) vaginal washing of women in labor and their neonates.
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.
Maternal demographics did not differ between the groups. No case of maternal rash occurred; 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.
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.
确定在分娩期间对妇女及其新生儿进行 1%洗必泰（CHX）阴道冲洗的安全性、可接受性和抗菌效果。
对 1%CHX 阴道和新生儿冲洗与不冲洗（常规护理[UC]）进行随机对照试验。该研究纳入了 502 名妇女（334 名 CHX，168 名 UC），分娩了 508 名活产新生儿（335 名 CHX，173 名 UC）。主要结局指标是产妇不良反应的发生率、新生儿皮疹的发生率、新生儿擦拭前后腋窝温度以及阴道培养结果。
两组产妇的人口统计学特征无差异。未发生产妇皮疹病例；4%的妇女出现阴道烧灼感。8 名新生儿在 CHX 清洁后腋窝温度下降超过 1°C；2 名新生儿出现轻微皮疹。在基线时阴道培养阳性的妇女亚组中，1%CHX 冲洗 1 次后，56%的培养物生长被消除，冲洗 2 次后 86%的培养物生长被消除。
1%CHX 对新生儿是安全的，分娩期母亲耐受性良好，并且在治疗产时阴道感染方面有效。基于这些数据，使用 1%CHX 并针对降低新生儿败血症死亡率进行随机对照试验是合理的。
