Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: Clinical trial
Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: Clinical trial
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DOI：
10.1136/bmj.315.7102.216
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发表时间：
1997-07-26
影响因子：
--
通讯作者：
Miotti, PG
中科院分区：
文献类型：
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作者：
Taha, TE;Biggar, RJ;Miotti, PG
目的：确定是否在 delDesign 中使用消毒剂清洁产道：临床试验；两个月不干预，随后三个月干预，最后一个月不干预。地点：马拉维布兰太尔伊丽莎白女王中央医院（三级保健城市医院）。受试者：六个月内总共分娩的 6965 名妇女及其 7160 名婴儿。干预：每次分娩前进行阴道检查时，用 0.25% 洗必泰溶液手动擦拭产妇运河。干预期间出生的婴儿也用氯己定擦拭。主要指标：干预对新生儿和孕产妇发病率和死亡率的影响。结果：干预阶段纳入了3635名产下3743名婴儿的妇女，非干预阶段纳入了3330名产下3417名婴儿的妇女，母亲及其子女均未出现与干预相关的不良反应。在干预阶段弯曲的婴儿中，总体新生儿入院人数减少（634/3743 (16.9%) vs 661/3417 (19.3%)，P < 0.01），新生儿败血症入院人数也减少（每 1000 名活产儿 7.8 vs 17.9，P < 0.0002），总体新生儿死亡率（每 1000 名活产儿 28.6 vs 36.9）也减少了。 1000 名活产儿，P < 0.06），以及感染原因造成的死亡率（每 1000 名活产儿 2.4 比 7.3，P < 0.005）。在接受干预的母亲中，与分娩相关的入院人数减少（每 1000 次分娩 29.4 例 vs 40.2 例，P < 0.02）。因产后感染而入院（每 1000 次分娩中 1.7 例 vs 5.1 例，P = 0.02）和住院时间（Wilcoxan P = 0.008）。结论：用氯己定清洁产道可减少早期新生儿和产妇产后感染问题。该手术的安全性、简单性和低成本表明应将其视为标准护理，以降低婴儿和产妇发病率和死亡率。
Objective: To determine if cleansing the birth canal with an antiseptic at delDesign: Clinical trial; two months of no intervention were followed by three months of intervention and a final month of no intervention.Setting: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi.Subjects: A total of 6965 women giving birth in a six month period and their 7160 babies.Intervention: Manual wipe of the maternal canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine.Main Outcome Measures: Effects of the intervention on neonatal and maternal morbidity and mortality.Results: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase, There were no adverse reactions related to the intervention among the mothers al their children. Among infants bent in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P < 0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P < 0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P < 0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 Live births, P < 0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P< 0.02). as iz ere admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxan P = 0.008).Conclusions: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems, The safety, simplicity and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.