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米索前列醇600微克口服在第三产程积极处理中的作用:与缩宫素10国际单位肌内注射的比较研究

Role of Misoprostol 600 mcg Oral in Active Management of Third Stage of Labor: A Comparative Study with Oxytocin 10 IU i.m.

作者信息

Mukta Mani, Sahay Priti Bala

机构信息

Department of Obstetrics and Gynaecology, Rajendra Institute of Medical Sciences, Ranchi, India ; C/O: Dr. Arun Kumar, A-1, Aishwarya Residency, Argora Kathal More Road, Deepatoli, Pundag, Infront of Al-Rahmat Sun City, Ranchi, 834004 Jharkhand India.

Department of Obstetrics and Gynaecology, Rajendra Institute of Medical Sciences, Ranchi, India.

出版信息

J Obstet Gynaecol India. 2013 Oct;63(5):325-7. doi: 10.1007/s13224-012-0330-x. Epub 2013 May 3.

Abstract

OBJECTIVES

To compare oral misopostol 600 mcg with 10 IU units oxytocin i.m. in the active management of the third stage of labor.

MATERIALS AND METHODS

A total of 200 pregnant women of 34-42 weeks of gestation delivering vaginally in the Rajendra Institute of Medical Sciences, Ranchi, were selected for study. Hundred women received oral misoprostol 600 mg and 100 women received i.m. oxytocin 10 IU immediately after delivery of the baby and cord clamping by the method of randomization.

RESULTS

In the misoprostol group, mean blood loss is 145 ml, mean duration of the third stage of labor is 3.76 min, and mean fall in hemoglobin is 0.55 g/dl. In the oxytocin group, mean blood loss in 125.6 ml, mean duration of the third stage of labor in 3.50 min, and mean fall in hemoglobin is 0.48 g/dl. There was no significant difference between the two groups with regard to the above-mentioned factors. There were 8 cases of PPH in the misoprostol group and 6 cases in the oxytocin group. Twenty-two cases in the misoprostol group and 16 cases in the oxytocin group required additional oxytocics. Adverse effects like shivering and pyrexia were more in the misoprostol group.

CONCLUSION

Oral misoprostol is as effective as oxytocin in AMTSL and can be used safely in vaginal deliveries for prevention of PPH, especially in non-institutional deliveries and in places of low resource settings.

摘要

目的

比较口服600微克米索前列醇与肌肉注射10国际单位缩宫素在第三产程积极处理中的效果。

材料与方法

选取在兰契市拉金德拉医学科学研究所阴道分娩的200例妊娠34 - 42周的孕妇进行研究。通过随机化方法,100名妇女在胎儿娩出及脐带结扎后立即口服600毫克米索前列醇,100名妇女肌肉注射10国际单位缩宫素。

结果

米索前列醇组平均失血量为145毫升,第三产程平均持续时间为3.76分钟,血红蛋白平均下降0.55克/分升。缩宫素组平均失血量为125.6毫升,第三产程平均持续时间为3.50分钟,血红蛋白平均下降0.48克/分升。两组在上述因素方面无显著差异。米索前列醇组有8例产后出血,缩宫素组有6例。米索前列醇组22例和缩宫素组16例需要额外使用宫缩剂。米索前列醇组寒战和发热等不良反应更多。

结论

口服米索前列醇在第三产程积极处理中与缩宫素效果相同,可安全用于阴道分娩预防产后出血,尤其适用于非医疗机构分娩及资源匮乏地区。

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