Vallera Cristianna, Choi Lynn O, Cha Catherine M, Hong Richard W
Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 3325, Los Angeles, CA 90095-7403, USA.
Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 3325, Los Angeles, CA 90095-7403, USA.
Anesthesiol Clin. 2017 Jun;35(2):207-219. doi: 10.1016/j.anclin.2017.01.007. Epub 2017 Mar 30.
Uterine atony is a common cause of primary postpartum hemorrhage, which remains a major cause of pregnancy-related mortality for women worldwide. Oxytocin, methylergonovine, carboprost, and misoprostol are commonly used to restore uterine tone. Oxytocin is the first-line agent. Methylergonovine and carboprost are both highly effective second-line agents with severe potential side effects. Recent studies have called into question the effectiveness of misoprostol as an adjunct to other uterotonic agents, but it remains a useful therapeutic in resource-limited practice environments. We review the current role these medications play in the prevention and treatment of uterine atony.
子宫收缩乏力是原发性产后出血的常见原因，而产后出血仍是全球女性妊娠相关死亡的主要原因。缩宫素、甲基麦角新碱、卡前列素和米索前列醇常用于恢复子宫收缩力。缩宫素是一线用药。甲基麦角新碱和卡前列素都是高效的二线用药，但都有严重的潜在副作用。近期研究对米索前列醇作为其他宫缩剂辅助用药的有效性提出了质疑，但在资源有限的实际应用环境中，它仍是一种有用的治疗药物。我们综述了这些药物在预防和治疗子宫收缩乏力方面目前所起的作用。
