Zeng Yanfei, Zhang Yinghui, Zhen Manhua, Lao Li, Ma Yubo, Liu Li, Fan Dazhi, Ai Wen
Department of Obstetrics and Gynecology, Foshan Fosun Chancheng Hospital Foshan 528031, Guangdong, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University Hefei 230032, Anhui, China.
Am J Transl Res. 2022 Mar 15;14(3):1934-1951. eCollection 2022.
To evaluate the side-effects of oxytocin for the prevention of postpartum hemorrhage (PPH) in randomized controlled trials (RCTs).
Electronic databases (Web of Science, Embase, PubMed, Elsevier ScienceDirect, the Cochrane Library, and ClinicalTrials.gov) were searched from the beginning of indexing to Sep 2021. RCTs comparing oxytocin with non-oxytocin uterotonic agent(s) or non-pharmacologic interventions for the prevention of PPH were eligible.
Overall, sixty-one RCTs meeting the inclusion criteria were included, involving 68834 participants. Twenty-seven types of side-effects were reported in this study. There were 24, 35, or 2 trials assessed as high medium and low quality, respectively. Compared with non-oxytocin, oxytocin had significantly lower risk for shivering (RR=0.31, 95% CI=0.23-0.41, n=36680), fever (RR=0.27, 95% CI=0.20-0.37, n=34031), and diarrhea (RR=0.48, 95% CI=0.35-0.66, n=30883). Other side-effects were not found associated with oxytocin.
Oxytocin use was association with a significantly lower incidence of shivering, fever, and diarrhea events and did not increase risk of other side-effects during the third stage of labor. These observations may aid obstetricians and gynecologists in weighing up the benefits and risks associated with oxytocin in prevention and treatment of PPH during the third stage of labor.
在随机对照试验（RCT）中评估缩宫素预防产后出血（PPH）的副作用。
检索电子数据库（科学网、Embase、PubMed、爱思唯尔ScienceDirect、考克兰图书馆和ClinicalTrials.gov），检索时间从建库开始至2021年9月。比较缩宫素与非缩宫素子宫收缩剂或非药物干预措施预防PPH的RCT符合纳入标准。
总体而言，纳入了61项符合纳入标准的RCT，涉及68834名参与者。本研究报告了27种副作用。分别有24、35或2项试验被评估为高质量、中等质量和低质量。与非缩宫素相比，缩宫素发生寒战（RR=0.31，95%CI=0.23-0.41，n=36680）、发热（RR=0.27，95%CI=0.20-0.37，n=34031）和腹泻（RR=0.48，95%CI=0.35-0.66，n=30883）的风险显著更低。未发现其他副作用与缩宫素有关。
使用缩宫素与寒战、发热和腹泻事件的发生率显著降低相关，并且在分娩第三产程中不会增加其他副作用的风险。这些观察结果可能有助于妇产科医生权衡缩宫素在预防和治疗分娩第三产程PPH时的利弊。
