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Prevention of Perinatal Sepsis (PoPS): Evaluation of Chlorhexidine Wipes of Birth Canal and Newborn

Phase 3
Conditions
Infant, Newborn, Diseases
Sepsis
Puerperal Infection
Interventions
Procedure: sterile water external genital wipe
Procedure: Birth canal wipe
Registration Number
NCT00136370
Lead Sponsor
Centers for Disease Control and Prevention
Brief Summary

The purpose of this study is to evaluate whether use of the disinfectant chlorhexidine administered to the birth canal during labour and newborn at delivery can protect a woman and her baby from bacterial infections after birth. If effective, this could be used as an inexpensive alternative to antibiotics to prevent newborn infections in resource-poor countries.

Detailed Description

We are conducting a randomized, controlled clinical trial in Soweto, South Africa to evaluate the efficacy of 0.5% chlorhexidine wipes of the birth canal during labour and of the infant at birth in reducing 1) vertical transmission of leading pathogenic bacteria from mother to child during labour and delivery, and 2) incidence of neonatal sepsis and maternal peripartum infection, in comparison to external genitalia sterile water wipes. In conjunction with this, we will compare vaginal carriage of bacteria commonly associated with neonatal sepsis and maternal peripartum infection among HIV-infected and non-infected pregnant women who deliver at the only public hospital in Soweto, and will characterize the burden of disease and risk factors for maternal peripartum infection and serious neonatal infections in this population by conducting active prospective surveillance.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
8000
Inclusion Criteria
  • Pregnant
  • Plan to deliver at Chris Hani Baragwanath Hospital or one of its satellite clinics
  • Plan to remain in Soweto for at least two months after delivery
  • Are able to understand and give informed consent
  • Are at least 15 years old at time of registration
Exclusion Criteria
  • Planned delivery by caesarean section
  • Antenatal ultrasound revealing major fetal congenital anomalies
  • Have known or suspected condition in which vaginal exams are contraindicated, e.g. placenta previa
  • Have a history of allergic reaction to any topical antiseptic solution
  • Present to labour ward with infant born before arrival
  • Present to labour ward with significant vaginal bleeding during labour
  • Present with known intrauterine fetal death prior to randomization
  • Subject noted to be in full cervical dilatation or have baby's head on perineum
  • Infant noted to be in face presentation on first vaginal examination
  • Noted to have genital ulcers present on first vaginal examination

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1ChlorhexidineChlorhexidine Vaginal Wipe
1Birth canal wipeChlorhexidine Vaginal Wipe
2sterile water external genital wipeSterile water external genital wipe
Primary Outcome Measures
NameTimeMethod
Rates of culture-confirmed or clinical neonatal sepsis, < 3 days of life
Rate of vertical transmission of colonization with group B streptococcus (GBS)
Secondary Outcome Measures
NameTimeMethod
Rates of culture-confirmed or clinical neonatal sepsis (non-nosocomial), 3 to 28 days of life
Rates of serious maternal per partum infections including: endometritis, culture-confirmed post-partum sepsis, and post-partum perineal wound infection
Rates of neonatal hospitalization, < 3 days of life
Rates of neonatal hospitalization, < 28 days of life
Rates of neonatal hospitalization, suspected sepsis
Rate of vertical transmission of colonization with E. coli or Klebsiella species

Trial Locations

Locations (1)

Chris Hani Baragwanath Hospital

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Soweto, Gauteng, South Africa

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