Güngördük Kemal, Asicioglu Osman, Celikkol Ozgu, Olgac Yusuf, Ark Cemal
Erzincan Military Hospital, Turkey.
Aust N Z J Obstet Gynaecol. 2010 Feb;50(1):36-9. doi: 10.1111/j.1479-828X.2009.01106.x.
The purpose of this prospective, randomised, double-blind, placebo-controlled study was to assess the effects of a 5-IU oxytocin bolus and placebo infusion versus a 5-IU oxytocin bolus and 30 IU infusion on the control of blood loss at elective lower segment caesarean section (C/S).
Participants with indication for elective C/S were randomly allocated to two groups. Group A, 360 women, received oxytocin 5 IU bolus and placebo; group B, 360 women received oxytocin 5 IU bolus and 30 IU infusion. Blood loss was estimated based on the haematocrit values before and 48 h after delivery. The primary outcome was the incidence of excessive bleeding (estimated blood loss of >1000 mL), while secondary outcomes included use of additional uterotonics, estimated blood loss, need for blood transfusion, duration of hospital stay and the incidence of adverse effects.
No demographic difference was observed between groups. Mean estimated blood loss (P < 0.001) and the proportion of women with blood loss estimated to be greater than 1000 mL were significantly less for group B than for group A (relative risk (RR) 0.35, 95% confidence interval (CI) 0.20-0.63). In addition, more women in the group A required additional uterotonic agents (RR 0.35, 95% CI 0.22-0.56) and blood transfusion (RR 0.12, 95% CI 0.01-0.98).
An additional oxytocin infusion after 5 IU oxytocin bolus infusion at elective C/S may reduce blood loss and required blood transfusion.
本前瞻性、随机、双盲、安慰剂对照研究旨在评估在择期下段剖宫产术中，5国际单位缩宫素推注联合安慰剂输注与5国际单位缩宫素推注联合30国际单位输注对控制失血的效果。
有择期剖宫产指征的参与者被随机分为两组。A组360名女性，接受5国际单位缩宫素推注和安慰剂；B组360名女性，接受5国际单位缩宫素推注和30国际单位输注。根据分娩前和分娩后48小时的血细胞比容值估计失血量。主要结局是大出血（估计失血量>1000毫升）的发生率，次要结局包括额外使用宫缩剂、估计失血量、输血需求、住院时间和不良反应发生率。
两组之间未观察到人口统计学差异。B组的平均估计失血量（P<0.001）和估计失血量大于1000毫升的女性比例显著低于A组（相对风险（RR）0.35，95%置信区间（CI）0.20-0.63）。此外，A组中更多女性需要额外使用宫缩剂（RR 0.35，95%CI 0.22-0.56）和输血（RR 0.12，95%CI 0.01-0.98）。
在择期剖宫产术中，5国际单位缩宫素推注后额外输注缩宫素可能减少失血量和输血需求。
