Ghulmiyyah Labib M, Wehbe Salim A, Saltzman Steven L, Ehleben Carol, Sibai Baha M
Department of Obstetrics & Gynecology, Atlanta Medical Center, Atlanta, Georgia, USA.
Am J Perinatol. 2007 Jun;24(6):347-52. doi: 10.1055/s-2007-981854. Epub 2007 Jun 12.
The objective of this study was to determine whether intraumbilical injection of oxytocin shortens the third stage of labor. A randomized, double-blind, placebo-controlled trial was used to assess the effectiveness of an intraumbilical injection of oxytocin on the duration of the third stage. Following randomization, each of 79 women received 30 mL of saline ( N = 40) or 20 U of oxytocin in 30 mL of saline ( N = 39). The primary outcome of interest was the effect on the duration of the third stage. Secondary outcomes examined were change in hemoglobin and percentage of undelivered placenta after 15 minutes. There was no difference in the duration of the third stage between the two groups (7.8 +/- 6.1 min in the saline-only group versus 5.9 +/- 2.6 min in the oxytocin group). The change in hemoglobin was significantly lower in the oxytocin group (1.3 +/- 0.9 g/dL in the oxytocin group versus 1.8 +/- 0.9 g/dL in the saline-only group). The percentage of undelivered placentas beyond 15 minutes was significantly lower in the oxytocin group (0% in the oxytocin group versus 12.5% in the saline-only group). The study concluded that intraumbilical vein injection of oxytocin reduced the rate of placentas remaining undelivered beyond 15 minutes and subsequent blood loss.
本研究的目的是确定脐内注射缩宫素是否能缩短第三产程。采用随机、双盲、安慰剂对照试验来评估脐内注射缩宫素对第三产程持续时间的有效性。随机分组后，79名女性中的每一位分别接受30毫升生理盐水（N = 40）或30毫升生理盐水中含20单位缩宫素（N = 39）。感兴趣的主要结局是对第三产程持续时间的影响。检查的次要结局是15分钟后血红蛋白的变化以及未娩出胎盘的百分比。两组第三产程的持续时间没有差异（仅生理盐水组为7.8±6.1分钟，缩宫素组为5.9±2.6分钟）。缩宫素组血红蛋白的变化显著更低（缩宫素组为1.3±0.9克/分升，仅生理盐水组为1.8±0.9克/分升）。缩宫素组15分钟后未娩出胎盘的百分比显著更低（缩宫素组为0%，仅生理盐水组为12.5%）。该研究得出结论，脐静脉注射缩宫素降低了15分钟后胎盘仍未娩出的发生率及随后的失血量。
