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米索前列醇在产后出血治疗中的应用:一种药物流行病学方法。

Use of misoprostol in the treatment of postpartum hemorrhage: a pharmacoepidemiological approach.

作者信息

Koch Daeska Marcella, Rattmann Yanna Dantas

机构信息

Universidade Federal do Paraná, Curitiba, PR, Brazil.

出版信息

Einstein (Sao Paulo). 2019 Nov 7;18:eAO5029. doi: 10.31744/einstein_journal/2020AO5029. eCollection 2020.

Abstract

OBJECTIVE

To characterize the use of the drug misoprostol for treatment of postpartum hemorrhage in pregnant women.

METHODS

A descriptive observational study was carried out with secondary data from pregnant women who used misoprostol to treat postpartum hemorrhage in a reference public maternity, from July 2015 to June 2017. Clinical and sociodemographic profiles of pregnant women, how misoprostol was used and success rate in controling postpartum hemorrhage were characterized.

RESULTS

A total of 717 prescriptions of misoprostol were identified. Of these, 10% were for treatment of postpartum hemorrhage. The majority of pregnant women were young adults, married, with complete high school education, white, residing in urban areas, multiparous (68.1%) and 25% had previous cesarean sections. The mean gestational age was 39 weeks and 51.4% had a cesarean section. There was prophylactic use of oxytocin in 47.2% of women. Treatment of postpartum hemorrhage was successful in 84.7% of women. Of these, 79.2% also used oxytocin and 54.2% methylergonovine. Only 13.5% of pregnant women had less than five prenatal visits, and the main cause of postpartum hemorrhage was uterine atony. There were 13 complications after hemorrhage, 15.3% required blood transfusion and there was one case of maternal death.

CONCLUSION

Misoprostol showed to be effective and safe for treating postpartum hemorrhage.

摘要

目的

描述米索前列醇在治疗孕妇产后出血中的应用情况。

方法

采用描述性观察研究,利用2015年7月至2017年6月期间在一家参考公立妇产医院使用米索前列醇治疗产后出血的孕妇的二手数据。对孕妇的临床和社会人口学特征、米索前列醇的使用方式以及控制产后出血的成功率进行了描述。

结果

共识别出717份米索前列醇处方。其中,10%用于治疗产后出血。大多数孕妇为年轻成年人,已婚,接受过完整的高中教育,白人,居住在城市地区,经产妇(68.1%),25%曾有剖宫产史。平均孕周为39周,51.4%的孕妇进行了剖宫产。47.2%的女性预防性使用了缩宫素。84.7%的女性产后出血治疗成功。其中,79.2%的女性还使用了缩宫素,54.2%使用了甲基麦角新碱。只有13.5%的孕妇产前检查次数少于5次,产后出血的主要原因是子宫收缩乏力。出血后有13例并发症,15.3%需要输血,有1例产妇死亡。

结论

米索前列醇在治疗产后出血方面显示出有效且安全。

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