Department of Obstetrics and Gynaecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
BJOG. 2013 Apr;120(5):531-40. doi: 10.1111/1471-0528.12134. Epub 2013 Jan 18.
The efficacy of misoprostol versus oxytocin for reducing blood loss during caesarean section remains unclear.
To conduct a meta-analysis comparing the efficacy of misoprostol with that of oxytocin in reducing blood loss during caesarean section.
We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov for randomised controlled trials (RCTs) using the keywords 'misoprostol', 'oxytocin' and 'caesarean section'.
Refereed publications examining the efficacy of misoprostol and oxytocin for reducing blood loss during caesarean section.
Two of the authors independently abstracted data from original articles. A fixed-effects or random-effects model was used, depending on the heterogeneity of the data, to estimate the risk ratio (RR), risk difference (RD) or weighted mean difference (WMD) with 95% confidence intervals (95% CIs).
A total of 646 pregnant women were included in this analysis. There was a significant difference in estimated blood loss between the misoprostol and the oxytocin groups (WMD-64.09; 95% CI-119.86--8.31). However, differences in haemoglobin levels (WMD-0.04; 95% CI-0.18-0.10), additional oxytocic therapy requirements (RD .03; 95% CI -0.04-0.10) and blood transfusion requirements (RD 0.00; 95% CI-0.03-0.02) between the two groups failed to reach statistical significance. The incidence of postoperative shivering/pyrexia was significantly higher in the misoprostol group, compared with the oxytocin group (RR 3.23; 95% CI 1.41-7.39).
AUTHORS' CONCLUSIONS: The results suggest that misoprostol is as effective as oxytocin for reducing blood loss during caesarean section. However, further research into treatment strategies is needed.
米索前列醇与缩宫素在剖宫产术中减少出血量的效果仍不清楚。
对米索前列醇与缩宫素在剖宫产术中减少出血量的效果进行荟萃分析。
我们使用“米索前列醇”、“缩宫素”和“剖宫产术”等关键词，在 MEDLINE、Embase、Cochrane 中心对照试验注册库（CENTRAL）和 ClinicalTrials.gov 中搜索了随机对照试验（RCT）。
评估米索前列醇和缩宫素在剖宫产术中减少出血量效果的同行评议出版物。
两名作者独立从原始文章中提取数据。根据数据的异质性，使用固定效应或随机效应模型来估计风险比（RR）、风险差（RD）或加权均数差（WMD），置信区间（95%CI）为 95%。
共有 646 名孕妇纳入本分析。米索前列醇组与缩宫素组的估计出血量有显著差异（WMD-64.09；95%CI-119.86--8.31）。然而，两组间血红蛋白水平（WMD-0.04；95%CI-0.18-0.10）、额外缩宫素治疗需求（RD.03；95%CI-0.04-0.10）和输血需求（RD 0.00；95%CI-0.03-0.02）差异无统计学意义。与缩宫素组相比，米索前列醇组术后寒战/发热的发生率明显更高（RR 3.23；95%CI 1.41-7.39）。
结果表明，米索前列醇与缩宫素在剖宫产术中减少出血量的效果相当。然而，仍需要进一步研究治疗策略。
