Mahmud Ghazala, Javaid Kiran, Tasnim Nasira, Tabassum Arfa, Bangash Kausar Tasneem
J Pak Med Assoc. 2014 Aug;64(8):911-4.
To compare the safety and efficacy of 10 units of intravenous syntocinon alone with 10 units intravenous syntocinon and 0.25 mg intramuscular ergometrine in the prevention of atonic uterine haemorrhage during caesarean section.
The quasi-experimental study was conducted at the Maternal and Child Health Centre, Unit I, Pakistan Institute of Medical Sciences, Islamabad, from November 1, 2010 to February 28, 2011. All women undergoing caesarean section were included in the study. Patients were given intravenous 10 units syntocinon alone intraoperatively from November 1 to December 31,2010, while 0.25 mg ergometrine intramuscular was added to 10 units intravenous syntocinon from January 1 to February 28, 2011. Frequency of postpartum haemorrhage, adverse effects of drugs and maternal morbidity and mortality were assessed by using chi square test. P < 0.05 was taken as statistically significant.
Of the total number of 701 subjects, 378 (54%) women were given 10 units syntocinon and 323 (46%) were given 0.25 mg ergometrine in addition to 10 units syntocinon. The mean age in the syntocinon group was 28 +/- 3.5 yrs with gestational age of 37.5 +/- 2 wks, while that in syntocinon-ergometrine group was 29 +/- 3.4 years and 38 +/- 2 weeks respectively. Postpartum haemorrhage in the syntocinon group was found in 38 (10%) women versus 05 (1.5%) women) in the other group (p < 0.001). Adverse effects like nausea, vomiting and raised blood pressure were slightly more with syntocinon-ergometrine than syntocinon alone (n = 56; 15.3% vs n = 35; 9.2%), but it was not statistically significant. Post partum haemorrhage was responsible for 40% of maternal mortality during the study period and that was in the syntocinon group.
Prophylactic ergometrine in addition to syntocinon is superior to syntocinon alone in decreasing frequency of postpartum haemorrhage in caesarean section and associated maternal morbidity and mortality. Regarding safety profile, the two groups showed no statistically significant change.
比较单纯静脉注射10单位缩宫素与静脉注射10单位缩宫素加肌内注射0.25毫克麦角新碱在剖宫产术中预防宫缩乏力性产后出血的安全性和有效性。
这项准实验性研究于2010年11月1日至2011年2月28日在伊斯兰堡巴基斯坦医学科学研究所第一单元母婴健康中心进行。所有接受剖宫产的妇女均纳入研究。2010年11月1日至12月31日，患者术中仅静脉注射10单位缩宫素，而2011年1月1日至2月28日，在静脉注射10单位缩宫素的基础上加用0.25毫克麦角新碱肌内注射。采用卡方检验评估产后出血频率、药物不良反应以及孕产妇发病率和死亡率。P<0.05被视为具有统计学意义。
在总共701名受试者中，378名（54%）妇女接受了10单位缩宫素，323名（46%）妇女在接受10单位缩宫素的基础上还接受了0.25毫克麦角新碱。缩宫素组的平均年龄为28±3.5岁，孕周为37.5±2周，而缩宫素-麦角新碱组的平均年龄分别为29±3.4岁和38±2周。缩宫素组有38名（10%）妇女发生产后出血，而另一组有5名（1.5%）妇女发生产后出血（P<0.001）。与单纯使用缩宫素相比，缩宫素-麦角新碱组出现恶心、呕吐和血压升高等不良反应的情况略多（n = 56；15.3%对n = 35；9.2%），但无统计学意义。在研究期间，产后出血导致了40%的孕产妇死亡，且均发生在缩宫素组。
在剖宫产术中，缩宫素加用预防性麦角新碱在降低产后出血频率以及相关孕产妇发病率和死亡率方面优于单纯使用缩宫素。在安全性方面，两组无统计学意义上的显著差异。
