is exceptionally rare a baby born at term with normal birth weight dies of an infection of streptococcus B. The most vulnerable are premature or too small for its time. Three studies published in medical journals suggest that authorized the use of vaginal chlorhexidine spray is as effective as antibiotics. For mysterious reasons, these studies are not well known. I include the abstract of the most recent. It is best not to administer eye drops to the baby after birth and depend on the results of an antibiogram (for the unlikely possibility of an eye infection.) Abstract: -1 - Facchinetti F, Piccinini F, Mordini B, Volpe AJ Matern Fetal Med 2002 Feb; 11 (2) :84-8 Irrigation Chlorhexidine vaginal versus systemic ampicillin in preventing vertical transmission of GBS to the newborn at term (Chlorhexidine vaginal flushings versus systemic ampicillin in the prevention of vertical transmission of neonatal group B streptococcus, at term).
OBJECTIVE: To investigate the efficacy of intrapartum vaginal irrigation with chlorhexidine compared with ampicillin in preventing streptococcal B transmission to newborns.
METHODS: This was a randomized controlled, including individual pregnancies with vaginal deliveries. Rupture membranes in the presence, should not have been practiced for more than six hours prior. Were excluded women with any gestational complication, with a newborn previously affected by group B streptococci, sepsis or whose cervical dilatation was greater than 5 cm. Were randomly selected a total of 244 women at term with group B streptococci (examined between weeks 36-38) to receive either 140 ml with 0.2% chlorhexidine vaginal irrigation every 6 hrs or ampicillin 2 g intravenously every 6 hours the delivery. Neonatal samples were taken at birth, at three different sites (nose, ear and gástico juice).
RESULTS: A total of 108 women were treated with ampicillin and 109 with chlorhexidine. Their ages and gestational age at the time of birth were similar in both groups. Nulliparous women were distributed equally between the two groups (ampicillin, 87% chlorhexidine, 89%). Clinical data such as birth weight (ampicillin, 3.365 + / - 390 g, chlorhexidine, 3.440 + / - 452 g), Apgar points at 1 min (ampicillin, 8.4 + / - 0.9; chlorhexidine, 8.2 + / - 1.4 ) and 5 min (ampicillin, 9.7 + / - 0.6; chlorhexidine, 9.6 + / - 1.1) were similar for both groups, as well as the rate of newborns with group B streptococci (chlorhexidine, 15.6%, ampicillin, 12%). On the other hand, E. Coli was significantly more prevalent in the ampicillin group (7.4%) than the chlorhexidine group (1.8%, p <>
CONCLUSIONS: In this population carefully studied, intrapartum chlorhexidine vaginal irrigations in colonized women showed the same efficacy as ampicillin in preventing vertical transmission of group B streptococci addition, the rate of E. coli in infants was reduced by chlorhexidine.
previous references: -2 - Burman LG, et al. Prevention of excess neonatal morbidity associated with group B streptococci (Prevention of Excess Neonatal Morbidity associated with group B streptococci). Lancet 1992, 340: 1965-1969 -3 - Taha TE, et al. Effectiveness of cleaning the birth canal with antiseptic solution (Effect of cleansing the birth canal with antiseptic solution). BMJ 1997; 315: 216-20.
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