Effect of predelivery vaginal antisepsis on maternal and neonatal morbidity and mortality in Egypt.
OBJECTIVE
The objective of this study was to determine if cleansing the birth canal with an antiseptic solution at delivery reduces infections in mothers and their newborn babies.


METHODS
Women giving birth in the University Hospital, Alexandria, and their newborns were studied. No intervention for 3 months was followed by 3 months of intervention. Intervention consisted of manually wiping the maternal birth canal with a 0.25% chlorhexidine solution at admission and at every vaginal examination before delivery. Babies were also wiped with chlorhexidine.


RESULTS
The study enrolled 4415 women and 4431 newborns. The nonintervention phase comprised 2128 mothers and 2138 newborns, and 2287 mothers and 2293 babies were enrolled in the intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. There was no difference in the overall number of neonatal admissions in both groups, but the admissions because of infection, deaths, and mortalities from infection were significantly less in the intervention group. Among mothers receiving the intervention, admissions, deaths, and infections were significantly reduced.


CONCLUSIONS
Cleansing the birth canal with chlorhexidine reduced neonatal and maternal postpartum infections. The safety, simplicity, and low cost of the procedure suggest that it should be considered standard care for the reduction of infant and maternal morbidity and mortality.
Bakr
Ahmad F
AF
Department of Pediatrics, University of Alexandria, Alexandria, Egypt. afb1963@hotmail.com
Karkour
Tarek
T
D000282:Administration, Intravaginal; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D017053:Infection Control / Q000379:methods / Q000706:statistics & numerical data*; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000188:drug therapy; D011247:Pregnancy; D011645:Puerperal Infection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000188:drug therapy
D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine