Yildirim Dogukan, Ozyurek Sefik Eser
Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Kucukcekmece, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Bagcilar Training and Research Hospital, Bagcilar, Istanbul, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2018 May;224:47-51. doi: 10.1016/j.ejogrb.2018.03.012. Epub 2018 Mar 9.
Postpartum hemorrhage is still the most significant cause of maternal mortality and morbidity worldwide. Our aim was to evaluate the effect of timing of oxytocin administration on postpartum hemorrhage incidence in parturients with low-risk for postpartum hemorrhage.
A randomized controlled trial was completed on 343 women at a level-three care hospital. In group 1, 10 IU of oxytocin was injected intramuscularly within the first minute following the delivery of the fetus. Group 2 received 10 IU of intramuscular oxytocin immediately following placental delivery. The primary outcome parameters were the incidence of postpartum hemorrhage and the measured blood loss.
The rate of postpartum hemorrhage, defined as estimated blood loss >500 mL, did not differ significantly between the two groups (7/172 (4.1%) in group 1 vs. 10/171 (5.8%) in group 2, P = .45). The mean blood loss did not differ significantly between the two groups (192.18 ± 135.7 in group 1 vs. 198.92 ± 165.4 mL in group 2, P = .68). The duration of the third stage was significantly shorter in group 1. There were no significant differences between the two groups with respect to the mean changes in hemoglobin and hematocrit, postpartum 24th hour hemoglobin and hematocrit, the additional use of oxytocin, manual expulsion of placenta, curettage, blood transfusion demand, uterine atony, and lengthening of the third stage.
In a level-three care hospital, timing of intramuscular oxytocin administration did not influence the incidence of postpartum hemorrhage in women with low risk of postpartum hemorrhage.
产后出血仍是全球孕产妇死亡和发病的最重要原因。我们的目的是评估缩宫素给药时机对产后出血低风险产妇产后出血发生率的影响。
在一家三级护理医院对343名女性完成了一项随机对照试验。第1组在胎儿娩出后的第一分钟内肌肉注射10国际单位缩宫素。第2组在胎盘娩出后立即肌肉注射10国际单位缩宫素。主要结局参数是产后出血发生率和测量的失血量。
产后出血率定义为估计失血量>500毫升，两组之间无显著差异（第1组为7/172（4.1%），第2组为10/171（5.8%），P = 0.45）。两组之间的平均失血量无显著差异（第1组为192.18±135.7，第2组为198.92±165.4毫升，P = 0.68）。第1组第三产程的持续时间明显较短。两组在血红蛋白和血细胞比容的平均变化、产后第24小时血红蛋白和血细胞比容、缩宫素的额外使用、人工剥离胎盘、刮宫、输血需求、子宫收缩乏力以及第三产程延长方面无显著差异。
在三级护理医院，肌肉注射缩宫素的时机对产后出血低风险女性的产后出血发生率没有影响。
