Department of Obstetrics and Gynecology, Women's Health Centre, Assiut University Hospital, Assiut, Egypt.
Int J Gynaecol Obstet. 2010 Oct;111(1):32-6. doi: 10.1016/j.ijgo.2010.04.036.
To determine the effectiveness of sustained uterine massage started before delivery of the placenta in reducing postpartum hemorrhage.
A randomized controlled trial conducted in Egypt and South Africa between September 2006 and February 2009. A total of 1964 pregnant women were randomly allocated to 1 of 3 treatment groups: intramuscular oxytocin, sustained uterine massage, or both treatments. Blood loss within 30 minutes of delivery was recorded.
The incidence of blood loss of 300 mL or more within 30 minutes of delivery was significantly higher in the massage group than in the massage plus oxytocin (RR 1.88; 95% CI, 1.29-2.74 in Assiut, and RR 1.3; 95% CI, 1.00-1.68 in SA) and the oxytocin only group (RR 1.7; 95% CI, 1.11-2.61 in Assiut, and RR 2.24; 95% CI, 1.54-3.27 in SA). In both centers, use of additional uterotonics was significantly higher in the uterine massage group compared with the other 2 groups.
Uterine massage was less effective than oxytocin for reducing blood loss after delivery. When oxytocin was used, there was no additional benefit from uterine massage. The effectiveness of uterine massage in the absence of oxytocin was not studied. ACTRN: 12609000372280.
评估在胎盘娩出前开始进行持续子宫按摩以减少产后出血的效果。
这是一项于 2006 年 9 月至 2009 年 2 月在埃及和南非进行的随机对照试验。共有 1964 名孕妇被随机分配至 3 个治疗组中的 1 个：肌内注射催产素、持续子宫按摩或两种治疗方法联合应用。记录分娩后 30 分钟内的失血量。
与催产素加按摩组（Assiut 比值比为 1.88；95%可信区间为 1.29-2.74；SA 比值比为 1.3；95%可信区间为 1.00-1.68）和仅用催产素组（Assiut 比值比为 1.7；95%可信区间为 1.11-2.61；SA 比值比为 2.24；95%可信区间为 1.54-3.27）相比，按摩组在分娩后 30 分钟内失血量达到 300 毫升或以上的发生率明显更高。在两个中心，与其他两组相比，按摩组中额外使用子宫收缩剂的情况明显更多。
与催产素相比，子宫按摩在减少产后出血方面效果较差。当使用催产素时，子宫按摩没有额外获益。在没有使用催产素的情况下，子宫按摩的效果尚未研究。ACTRN：12609000372280。
