Al-Harazi Abdelrahman H, Frass Kaima A
Department of Obstetrics & Gynecology, Faculty of Medicine, Thamar University, Sana'a, Yemen.
Saudi Med J. 2009 Jul;30(7):912-6.
To compare the effectiveness of misoprostol (600 microg) when administered sublingually with the same dose administered per rectum to patients, immediately after delivery in preventing postpartum hemorrhage (PPH).
This study was carried out in Al Thawra General Hospital, Sana'a, Yemen, from May 1, 2007 to April 31, 2008. A total of 215 women were recruited, and divided into 2 groups in a quasi-random fashion. Group I comprised 118 women, and was given 600 ug misoprostol sublingually immediately after delivery. The other group comprised 97 women (group II), and was given the same dose of misoprostol per rectum. The blood loss was measured, and the side effects of the misoprostol were assessed. The need for additional uterotonic agents, blood transfusion, and the length of the third stage labor were recorded.
Nine patients in group I, and 7 patients in group II had PPH. Of these patients, blood loss was >1000 ml in 4 patients in group I, but <1500 ml in 3 patients in group II, (relative risk - 1.05, 0.40 - 2.73 confidence interval [95%]. The mean blood loss was 362.3 +/- 170 ml in group I versus 342.3 +/- 154.7 ml in group II. Only 3 cases (3%) of the patients in group I were given additional uterotonic agents versus 2 cases (2%) in group II.
Postpartum use of 600 microg misoprostol by sublingual route has a comparable effect in reducing PPH, as that of rectal route. It was observed that severe PPH (1000 ml but <1500 ml) had been observed in 40% of those who developed PPH in both groups.
比较产后立即给患者舌下含服米索前列醇（600微克）与直肠给予相同剂量米索前列醇在预防产后出血（PPH）方面的效果。
本研究于2007年5月1日至2008年4月31日在也门萨那的宰赫拉综合医院进行。共招募了215名妇女，并以半随机方式分为2组。第一组包括118名妇女，产后立即舌下给予600微克米索前列醇。另一组包括97名妇女（第二组），直肠给予相同剂量的米索前列醇。测量失血量，并评估米索前列醇的副作用。记录使用额外宫缩剂的必要性、输血情况及第三产程的时长。
第一组有9名患者、第二组有7名患者发生产后出血。在这些患者中，第一组有4名患者失血量>1000毫升，而第二组有3名患者失血量<1500毫升（相对风险 - 1.05，95%置信区间[0.40 - 2.73]）。第一组的平均失血量为362.3±170毫升，而第二组为342.3±154.7毫升。第一组仅有3例（3%）患者使用了额外的宫缩剂，而第二组为2例（2%）。
产后舌下使用600微克米索前列醇在减少产后出血方面与直肠给药效果相当。观察到两组中发生产后出血的患者中有40%出现了严重产后出血（1000毫升但<1500毫升）。
