Strand Roland T, Da Silva Florinda, Jangsten Elisabeth, Bergström Staffan
Division of International Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2005 Mar;84(3):260-5. doi: 10.1111/j.0001-6349.2005.00579.x.
Postpartum hemorrhage (PPH) is the single most common cause of maternal death in the world, and oxytocin is known to be effective for its prevention and treatment. The use of syringes can be problematic in areas affected by HIV. The aim of this study was to introduce Uniject (a new disposable device for administration of 10 IU oxytocin) as part of active management of the third stage of labor (AMTL) and try to reduce PPH.
A prospective, comparative study was performed between March 1998 and May 2000 in Luanda. Seven hundred and eighty-two parturient women with physiological management were compared to 814 with AMTL. Postpartum lost blood was collected using a plastic sheet during labor and a bucket placed under a cholera bed for 2 h postpartum. Student's t-test and chi(2) test were used.
PPH was reduced from 40.4 to 8.2% and severe PPH (> or =1000 ml) from 7.5 to 1% in the AMTL group (P < 0.001).
Uniject was well tolerated and offers an alternative for oxytocin administration. AMTL should be implemented also in resource-poor settings as a routine management to reduce PPH.
产后出血(PPH)是全球孕产妇死亡的最常见单一原因,已知催产素对其预防和治疗有效。在受艾滋病病毒影响的地区,使用注射器可能会有问题。本研究的目的是引入Uniject(一种用于注射10国际单位催产素的新型一次性装置)作为第三产程积极管理(AMTL)的一部分,并试图减少产后出血。
1998年3月至2000年5月在罗安达进行了一项前瞻性比较研究。将782例采用生理性管理的产妇与814例采用第三产程积极管理的产妇进行比较。分娩期间使用塑料布收集产后失血量,产后2小时在霍乱床上放置桶收集失血量。采用学生t检验和卡方检验。
第三产程积极管理组的产后出血率从40.4%降至8.2%,严重产后出血(≥1000毫升)率从7.5%降至1%(P<0.001)。
Uniject耐受性良好,为催产素给药提供了一种替代方法。在资源匮乏地区也应实施第三产程积极管理作为常规管理措施以减少产后出血。