Sunil Kumar K S, Shyam Sundar, Batakurki Pavitra
Department of OBGYN, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka 580009 India.
Department of OBGYN, Ashirwada Hospital, MIG 226, Navanagar, Hubli, Karnataka India.
J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):229-34. doi: 10.1007/s13224-016-0842-x. Epub 2016 Mar 22.
Postpartum hemorrhage is the single largest and leading cause of maternal morbidity and mortality not only in developing countries but also in developed countries. The present study is an attempt to evaluate the scope of using prophylactic intramuscular carboprost tromethamine 125 μg in comparison with intramuscular oxytocin 10 units for the active management of third stage of labor.
Two hundred pregnant women at term with spontaneous onset of labor were included in the study and were randomly divided into 2 groups of 100 women each. Group A and group B were given injection oxytocin 10 units and injection carboprost tromethamine 125 μg intramuscularly, respectively, at the time of delivery of anterior shoulder. The main outcome measures with respect to third stage of labor were: duration, blood loss by volume, difference in hemoglobin, need for additional oxytocics and side effects.
Subjects who received carboprost tromethamine 125 μg showed a significant reduction in duration of third stage of labor (p < 0.05) and blood loss (p < 0.01) when compared to the subjects who received oxytocin 10 units. Likelihood of occurrence of postpartum hemorrhage was reduced without significant side effects except for diarrhea. Additional need for other uterotonics after carboprost was significantly less compared to oxytocin.
Intramuscular carboprost 125 μg is a better cost-effective alternative as compared to 10 units intramuscular oxytocin in active management of third stage of labor.
产后出血不仅是发展中国家，也是发达国家孕产妇发病和死亡的单一最大且首要原因。本研究旨在评估与肌内注射10单位缩宫素相比，预防性肌内注射125μg卡前列甲酯栓用于积极处理第三产程的适用范围。
纳入200例足月自然临产的孕妇，随机分为两组，每组100例。A组和B组分别在胎头前肩娩出时肌内注射10单位缩宫素和125μg卡前列甲酯栓。第三产程的主要观察指标为：持续时间、失血量、血红蛋白差异、是否需要额外使用宫缩剂及副作用。
与接受10单位缩宫素的受试者相比，接受125μg卡前列甲酯栓的受试者第三产程持续时间显著缩短（p<0.05），失血量显著减少（p<0.01）。除腹泻外，产后出血发生的可能性降低，且无明显副作用。与缩宫素相比，使用卡前列甲酯栓后额外需要其他宫缩剂的情况显著减少。
在积极处理第三产程方面，与肌内注射10单位缩宫素相比，肌内注射125μg卡前列甲酯栓是一种更具成本效益的选择。
