Uncu Y, Karahasan M, Uyaniklar Ö, Uncu G
Department of Family Medicine, University of Uludag, School of Medicine, Bursa, Turkey.
Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):15-22.
Postpartum hemorrhage (PPH) is one of the major preventable causes of maternal death in developing countries. Although the non-parenteral use of misoprostol is a big advantage especially in home births, its benefits in prevention of PPH is still debating. We aimed to assess the effect and side-effects of prophylactic oral, rectal or vaginal misoprostol on preventing postpartum hemorrhage comparing with no-treatment option.
In a randomized clinical trial, during uncomplicated vaginal delivery, 248 women were assigned to receive one of the five treatment protocols in the third stage of labor which was managed routinely by early cord clamping and controlled cord traction. Maternal hemoglobin and hematocrit values, the duration of the third stage, and the incidence of blood transfusion was recorded.
There was no statistically significant differences between the antepartum and postpartum values of hemoglobin or hematocrit between the groups. The mean duration (11.8 ± 4.5 min) of the third stage of labor in oral+vaginal group was significantly shorter. Shivering was observed totally in 11 women and the differences were not significant between groups.
Despite misoprostol has benefit in treatment of postpartum hemorrhage, it has no remarkable effect in prophylaxis of atony-induced postpartum hemorrhage.
产后出血（PPH）是发展中国家孕产妇死亡的主要可预防原因之一。尽管米索前列醇的非肠道外使用具有很大优势，尤其是在家中分娩时，但它在预防产后出血方面的益处仍存在争议。我们旨在评估预防性口服、直肠或阴道使用米索前列醇与不治疗相比在预防产后出血方面的效果和副作用。
在一项随机临床试验中，在无并发症的阴道分娩过程中，248名妇女被分配在产程第三阶段接受五种治疗方案中的一种，产程第三阶段常规采用早断脐和控制脐带牵引进行管理。记录产妇的血红蛋白和血细胞比容值、第三产程持续时间以及输血发生率。
各组之间产前和产后血红蛋白或血细胞比容值无统计学显著差异。口服 + 阴道组第三产程的平均持续时间（11.8 ± 4.5分钟）显著更短。共有11名妇女出现寒战，各组之间差异不显著。
尽管米索前列醇在治疗产后出血方面有益，但它在预防宫缩乏力引起的产后出血方面没有显著效果。
