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分娩第三产程中预防性使用缩宫素与麦角新碱的随机对照研究

A randomized comparative study of prophylactic oxytocin versus ergometrine in the third stage of labor.

作者信息

Orji Ernest, Agwu Felix, Loto Olabisi, Olaleye Oladapo

机构信息

Department of Obstetrics, Gynecology and Perinatology, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

出版信息

Int J Gynaecol Obstet. 2008 May;101(2):129-32. doi: 10.1016/j.ijgo.2007.11.009. Epub 2008 Mar 4.

Abstract

OBJECTIVE

To compare the effect of prophylactic use of oxytocin and ergometrine in management of the third stage of labor.

METHODS

A prospective randomized study of 600 women assigned to receive either oxytocin or ergometrine in the third stage of labor. Outcome measures were the predelivery and 48-hour postdelivery hematocrit, duration of the third stage, specific side effects, and incidence of postpartum hemorrhage. Statistical analyses were done using the t test for continuous variables and chi2 test for categorical variables. The level of significance was set at P<0.05.

RESULTS

There were no significant differences between the 2 groups in maternal age, gestational age, duration of third stage, birth weights, risk for retained placenta, manual removal of placenta, or need for additional oxytocics. Patients in the ergometrine group were at significant risk for nausea, vomiting, headaches, and elevated blood pressure (P=0.0001).

CONCLUSION

Oxytocin is as effective as ergometrine at reducing the incidence of postpartum hemorrhage, but without the undesirable side effects of nausea, vomiting, and elevated blood pressure associated with ergometrine.

摘要

目的

比较预防性使用缩宫素和麦角新碱对第三产程的处理效果。

方法

一项前瞻性随机研究,600名妇女被分配在第三产程接受缩宫素或麦角新碱。观察指标为产前及产后48小时的血细胞比容、第三产程持续时间、特定副作用及产后出血发生率。连续变量采用t检验,分类变量采用卡方检验进行统计分析。显著性水平设定为P<0.05。

结果

两组在产妇年龄、孕周、第三产程持续时间、出生体重、胎盘残留风险、人工剥离胎盘或额外使用缩宫剂的需求方面无显著差异。麦角新碱组患者出现恶心、呕吐、头痛和血压升高的风险显著(P=0.0001)。

结论

缩宫素在降低产后出血发生率方面与麦角新碱同样有效,但没有麦角新碱相关的恶心、呕吐和血压升高等不良副作用。

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