Nirmala Kampan, Zainuddin Ani Amelia, Ghani Nur Azurah Abdul, Zulkifli Syed, Jamil Mohd Abdul
Department of Obstetrics and Gynaecology, National University of Malaysia, Malaysia.
J Obstet Gynaecol Res. 2009 Feb;35(1):48-54. doi: 10.1111/j.1447-0756.2008.00829.x.
To compare the efficacy of a single dose of 100 microg intramuscular carbetocin to a single dose of intramuscular syntometrine (0.5 mg ergometrine and 5IU oxytocin), in preventing post-partum hemorrhage (PPH) in high risk patients following vaginal delivery.
A prospective, randomized controlled study was conducted in a tertiary hospital where 120 pregnant women with risk factors for PPH who delivered vaginally were randomized into two groups: the study group where 100 microg intramuscular carbetocin was administered and the control group, who received intramuscular syntometrine. Outcome measures compared included changes in vital signs, amount of intrapartum blood loss, uterine fundal position, addition of another oxytocic agent, side-effects of the drugs, amount of lochia and hemoglobin drop after 24 hours post-partum. Incidence of PPH or other adverse events were also compared.
There were no significant differences in terms of requirement for additional oxytocic agents, time interval to well contracted uterus, blood transfusion requirements, adverse effects or complications. There was a significantly lower mean estimated blood loss in the carbetocin group compared to the syntometrine group (244 +/- 114 mL vs 343 +/- 143 mL, 95% CI 52-146 mL). There was also a significantly reduced drop in hemoglobin in the carbetocin group compared to the syntometrine group (0.3 +/- 0.2 g/dL vs 0.4 +/- 0.2 g/dL, 95% CI 0.1-0.2 g/dL).
Intramuscular carbetocin may be more effective than intramuscular syntometrine in reducing post-partum blood loss and the drop in hemoglobin level.
比较单剂量100微克肌肉注射卡贝缩宫素与单剂量肌肉注射合成宫缩素（0.5毫克麦角新碱和5国际单位缩宫素）在预防阴道分娩高危患者产后出血（PPH）方面的疗效。
在一家三级医院进行了一项前瞻性随机对照研究，将120例有产后出血危险因素且经阴道分娩的孕妇随机分为两组：研究组肌肉注射100微克卡贝缩宫素，对照组肌肉注射合成宫缩素。比较的结果指标包括生命体征变化、产时失血量、子宫底位置、是否加用其他宫缩剂、药物副作用、恶露量以及产后24小时血红蛋白下降情况。还比较了产后出血或其他不良事件的发生率。
在额外使用宫缩剂的需求、子宫收缩良好的时间间隔、输血需求、不良反应或并发症方面，两组无显著差异。与合成宫缩素组相比，卡贝缩宫素组的平均估计失血量显著更低（244±114毫升 vs 343±143毫升，95%可信区间52 - 146毫升）。与合成宫缩素组相比，卡贝缩宫素组的血红蛋白下降也显著减少（0.3±0.2克/分升 vs 0.4±0.2克/分升，95%可信区间0.1 - 0.2克/分升）。
肌肉注射卡贝缩宫素在减少产后失血量和血红蛋白水平下降方面可能比肌肉注射合成宫缩素更有效。
