Dimitrov A, Nikolov A, Krŭsteva K, Lazarova L, Gŭrchev E, Karag'ozov I
Akush Ginekol (Sofiia). 1999;38(4):15-7.
The aim of this prospective study is to asses, the possibility to use Remestyp after the delivery of the head as a prophylaxis of blood lost during the third stage of labor. The material includes 209 cases: 82 with bolus dose of 0.2 mg Methergin, 54 cases with 10 ME Oxytocin, 32 parturition with 200 mg Remestyp, and 41 controls without any uterostonics during the placental period. The blood lost is assessed by gravimetric method. The results show that the total blood lost from the delivery of the neonate to two hours after it is significantly lower in active management of labor than in expectant one. The type of uterostonic is not essential in regard of total blood lost. The prophylactics of blood lost with Remestyp has best results in cases of stimulated with Oxytocin infusion labor. The active management of third stage of labor with Methergin or Remestyp has less complication than are used oxytocin or without uterostonics. The mean time for delivery of placenta is shortest in the group with Remestyp. The three uterostonics in mansion doses do not influenced significantly the artery pressure. Our experience demonstrates that Remestyp can be used for active management of third stage of labor and the results are as those with Methergin. Remestyp is preferable when are expected significant lacerations of the birth canal.
这项前瞻性研究的目的是评估在胎头娩出后使用瑞美斯特（Remestyp）预防第三产程失血的可能性。研究材料包括209例病例：82例给予0.2毫克麦角新碱大剂量推注，54例给予10单位缩宫素，32例分娩时给予200毫克瑞美斯特，41例作为对照在胎盘娩出期未使用任何宫缩剂。采用重量法评估失血量。结果显示，与期待疗法相比，积极处理产程时从新生儿娩出到产后两小时的总失血量显著更低。就总失血量而言，宫缩剂的类型并非关键因素。在缩宫素静脉滴注引产的情况下，使用瑞美斯特预防失血效果最佳。使用麦角新碱或瑞美斯特积极处理第三产程比使用缩宫素或不使用宫缩剂并发症更少。使用瑞美斯特的组中胎盘娩出的平均时间最短。三种大剂量宫缩剂对动脉血压无显著影响。我们的经验表明，瑞美斯特可用于积极处理第三产程，其效果与麦角新碱相同。当预计有明显的产道裂伤时，瑞美斯特更为可取。
