Ragab Ahmed, Barakat Rafik, Alsammani Mohamed A
Department of Obstetrics and Gynecology, College of Medicine, Mansoura University, Mansoura, Egypt.
Department of Obstetrics and Gynecology, College of Medicine, Mansoura University, Mansoura, Egypt.
Int J Gynaecol Obstet. 2016 Jan;132(1):82-4. doi: 10.1016/j.ijgo.2015.06.057. Epub 2015 Oct 14.
To determine the optimum time for misoprostol administration to minimize blood loss during and after elective cesarean delivery.
A randomized clinical trial was conducted at Mansoura University Hospital, Egypt, between January 1, 2013, and December 31, 2014. Eligible participants had full-term pregnancies, were scheduled to have a cesarean, and had normal fetal heart tracing. Patients were randomly allocated into two equal groups using computer-generated tables and sealed opaque envelopes. Misoprostol (400μg, given rectally) was given either before (group 1) or after (group 2) surgery. Patients, investigators, and data analysts were not masked to group assignment. The primary outcome was blood loss.
A total of 348 women were included (174 in each group). Blood loss was significantly lower in group 1 than in group 2 (570±240 vs 844±270mL; P<0.001). The frequency of maternal and neonatal adverse events did not differ between the groups.
Preoperative misoprostol (400μg, given rectally) reduces blood loss to a greater extent than does postoperative misoprostol during elective cesarean delivery. The frequency of complications was not affected by time of administration.
确定米索前列醇给药的最佳时间，以尽量减少择期剖宫产术中及术后的失血量。
2013年1月1日至2014年12月31日在埃及曼苏拉大学医院进行了一项随机临床试验。符合条件的参与者为足月妊娠，计划进行剖宫产，且胎儿心率监测正常。使用计算机生成的表格和密封不透明信封将患者随机分为两组。米索前列醇（400μg，直肠给药）在手术前（第1组）或手术后（第2组）给药。患者、研究者和数据分析人员均未对分组情况设盲。主要结局指标为失血量。
共纳入348名女性（每组174名）。第1组的失血量显著低于第2组（570±240 vs 844±270mL；P<0.001）。两组间母婴不良事件的发生率无差异。
在择期剖宫产术中，术前直肠给予米索前列醇（400μg）比术后给予米索前列醇能更大程度地减少失血量。给药时间不影响并发症的发生率。
