Jhpiego, Baltimore, Maryland, USA.
Int J Gynaecol Obstet. 2010 Mar;108(3):276-81. doi: 10.1016/j.ijgo.2009.12.003. Epub 2010 Jan 6.
To test the safety, acceptability, feasibility, and effectiveness of community-based education and distribution of misoprostol for prevention of postpartum hemorrhage at home birth in Afghanistan.
A nonrandomized experimental control design in rural Afghanistan.
A total of 3187 women participated: 2039 in the intervention group and 1148 in the control group. Of the 1421 women in the intervention group who took misoprostol, 100% correctly took it after birth, including 20 women with twin pregnancies. Adverse effect rates were unexpectedly lower in the intervention group than in the comparison group. Among women in the intervention group, 92% said they would use misoprostol in their next pregnancy. In the intervention area where community-based distribution of misoprostol was introduced, near-universal uterotonic coverage (92%) was achieved compared with 25% coverage in the control areas.
In Afghanistan, community-based education and distribution of misoprostol is safe, acceptable, feasible, and effective. This strategy should be considered for other countries where access to skilled attendance is limited.
测试在阿富汗家庭分娩中，基于社区的米索前列醇教育和分发在预防产后出血方面的安全性、可接受性、可行性和有效性。
在阿富汗农村进行非随机实验对照设计。
共有 3187 名妇女参与：2039 名妇女在干预组，1148 名妇女在对照组。在接受米索前列醇干预的 1421 名妇女中，100%的妇女在产后正确服用了米索前列醇，包括 20 名怀有双胞胎的妇女。干预组的不良反应发生率意外低于对照组。在干预组中，92%的妇女表示她们在下一次怀孕时会使用米索前列醇。在引入基于社区的米索前列醇分发的干预地区，与对照组 25%的覆盖率相比，实现了近乎普遍的子宫收缩剂覆盖（92%）。
在阿富汗，基于社区的米索前列醇教育和分发是安全、可接受、可行和有效的。在获得熟练助产服务有限的其他国家，应考虑采用这种策略。
