Okonofua Friday Ebhodaghe, Ogu Rosemary Nkemdilim, Akuse James Terkura, Ujah Innocent Achaya Otobo, Galadanci Hadiza Shehu, Fabamwo Adetokunbo Olusegun
Department of Obstetrics and Gynecology, University of Benin, Benin City, Rivers State, Nigeria.
J Obstet Gynaecol Res. 2014 Mar;40(3):718-22. doi: 10.1111/jog.12257. Epub 2013 Dec 10.
The study investigated the effectiveness of sublingual misoprostol when used as primary treatment of primary post-partum hemorrhage (PPH) in a low-income country.
Maternity care providers in three Nigerian hospitals administrated 800 μm sublingual misoprostol to women experiencing PPH. The outcome variables were estimated blood loss and the need for additional uterotonic drugs after initial treatment with misoprostol. Entry criteria included women in term spontaneous labor, while exclusion criteria were women with operative delivery and those experiencing PPH not due to atonic uterus.
One hundred and thirty-one women with PPH were treated over 6 months. Estimated blood loss ranged 500-2500 mL. Twenty women (15.3%) required additional uterotonic drugs to control continuing blood loss. There were no maternal deaths, while seven perinatal deaths were recorded.
We conclude that although sublingual misoprostol is effective in reducing blood loss due to PPH, it does not effectively treat all forms of PPH. Additional uterotonics and other ancillary treatments would be required.
本研究调查了在低收入国家，舌下含服米索前列醇作为原发性产后出血（PPH）初始治疗方法的有效性。
尼日利亚三家医院的产科护理人员对发生PPH的妇女给予800μg舌下含服米索前列醇。观察指标为估计失血量以及在米索前列醇初始治疗后是否需要额外使用宫缩剂。纳入标准包括足月自然分娩的妇女，排除标准为接受手术分娩的妇女以及非宫缩乏力导致PPH的妇女。
在6个月内，共治疗了131例PPH妇女。估计失血量在500 - 2500mL之间。20名妇女（15.3%）需要额外使用宫缩剂来控制持续出血。无孕产妇死亡，记录到7例围产期死亡。
我们得出结论，尽管舌下含服米索前列醇在减少PPH导致的失血方面有效，但它不能有效治疗所有类型的PPH。可能需要额外的宫缩剂和其他辅助治疗。
