Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, India.
Arch Gynecol Obstet. 2014 Apr;289(4):739-42. doi: 10.1007/s00404-013-3026-2. Epub 2013 Sep 18.
Post-partum hemorrhage (PPH) is the most common direct cause of maternal mortality and timely intervention can save many lives.
To compare the effectiveness of sublingual misoprostol to intravenous oxytocin in preventing post-partum hemorrhage in low risk vaginal birth.
One hundred patients with no risk factor for PPH were randomly allocated to receive 600 μg misoprostol administered sublingually or 10 IU of intravenous oxytocin immediately after the delivery of baby. Main outcome measures were post-partum blood loss, drop in hemoglobin in 24 h, duration of third stage of labor, and drug-related adverse effects.
Mean age, parity and gestational age were similar in both groups. Mean blood loss was significantly lower in oxytocin group (114.28 ± 26.75 versus 149.50 ± 30.78 ml; p = 0.00). Drop in hemoglobin was 0.31 ± 0.16 versus 0.49 ± 0.21 g% (p = 0.01) in oxytocin and misoprostol group, respectively. Duration of third stage labor was shorter in oxytocin group (median 5 min, IQR: 4.5-5.5 versus 5.5 min, IQR: 5-6 min, p < 0.01). Although fever and shivering were common adverse effects with misoprostol but were not clinically significant.
Intravenous oxytocin is more efficacious than sublingual misoprostol in preventing PPH in institutional deliveries.
产后出血（PPH）是产妇死亡的最常见直接原因，及时干预可以挽救许多生命。
比较舌下含服米索前列醇与静脉滴注缩宫素预防低危阴道分娩产后出血的效果。
将 100 例无 PPH 危险因素的产妇随机分为舌下含服 600μg米索前列醇组或静脉滴注 10IU 缩宫素组，于胎儿娩出后立即给药。主要观察指标为产后出血量、24 小时血红蛋白下降、第三产程时间及药物相关不良反应。
两组产妇年龄、产次和孕周无显著差异。缩宫素组产后出血量明显少于米索前列醇组[（114.28±26.75）ml 比（149.50±30.78）ml，P=0.00]。缩宫素组血红蛋白下降 0.31±0.16g%，米索前列醇组下降 0.49±0.21g%（P=0.01）。缩宫素组第三产程时间更短[中位数 5min（IQR：4.55.5）比 5.5min（IQR：56），P<0.01]。米索前列醇组常见不良反应为发热和寒战，但无临床意义。
在机构分娩中，静脉滴注缩宫素比舌下含服米索前列醇更能有效预防 PPH。
