CHG prep for all vaginal deliveries?

Specialties Ob/Gyn

Published

Hi,

Our hospital wants to start using a CHG prep for ALL lady partsl deliveries and I would like to find out if anyone else is doing this. The plan is to prep while she is pushing or soon to deliver and allow solution to dry for 2 minutes. In addition to being a little inconvenient to do at that time I also thought that that was one of the perks of being born lady partslly; you got some of mom's bacteria to help colonize the newborn gut and create a better immune system. I understand if mom is GBS+ and we don't have time to get antibiotics on board, but it seems excessive and counter intuitive in the majority of cases.

Please fill me in on any experience you have with this.......

Thanks!

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Specializes in L&D.

We use betadine prep on lady partsl deliveries. I've always been under the impression that CHG is irritating to mucosa and shouldn't be used on delicate areas unless it's absolutely necessary. I know there are many facilities where no prep is used at all.

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Specializes in OB.

I cannot believe that there are still places "prepping" the perineum before delivery. Babies need to be exposed to bacteria on their way out, it's what helps colonize their gut. Studies comparing babies born by c-section who had none of that bacterial exposure support this as a possible reason why they are more prone to asthma and allergy problems. Allow to "dry" for 2 minutes during pushing??? How is that possible with all of the mucus and fluid coming out of the lady parts? Putting something as irritating as chlorhexidine to the already stretched, sensitive skin of the perineum? What is the point????

Sigh.

Not trying to attack YOU at all, just so disgusted with the lack of evidence-based practice in maternity care!

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Agree, lily

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Specializes in Community, OB, Nursery.

That just seems like overkill....our place doesn't prep anything on a vag delivery.

ETA - and come to think of it, our CHG bottle says specifically that it is NOT for use in the genital area.

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Specializes in OR, Nursing Professional Development.

While I don't work in L&D, I do work in the OR where we frequently perform lady partsl preps for bladder slings and hysters. For patients allergic to betadine, we have been told that CHG is an absolute no go as it is not recommended for mucous membranes. Once upon a time we used Technicare (aka snot, for how it looked), but that was pulled off the market. Now, if we get a patient allergic to betadine, we use castile soap and sterile saline.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

At the one facility I worked at that did do vag prep, we used Phisoderm and warm water.

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Specializes in L&D/Maternity nursing.

We do no prep on lady partsl deliveries

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Thanks for the feedback! LilyRoseCNM, I completely agree with you and that is why I asked this question. I have voiced my concerns at work and found a few articles to present as well. As of right now I think this practice change may get put on hold until we have more evidence (including our own stats)........fingers crossed! If you or anyone else knows of any specific articles or other references that would be helpful please share.

Thanks again

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