Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria.
Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Imo State, Nigeria.
Ghana Med J. 2022 Jun;56(2):55-63. doi: 10.4314/gmj.v56i2.1.
To determine the efficacy of intravenous tranexamic acid versus rectal misoprostol in decreasing intraoperative blood loss during caesarean section (C/S).
Randomised controlled study involving pregnant women undergoing C/S at Alex Ekwueme Federal University Teaching Hospital, Abakaliki in Nigeria.
Five hundred and fourteen women undergoing elective C/S were assigned randomly (257 patients per group) to receive either pre-operative 1000 µg rectal misoprostol or 1000mg intravenous tranexamic acid after spinal anaesthesia. Data from 248 patients were analysed in the misoprostol group, while data from 250 patients were analysed in the tranexamic acid group. Sixteen patients were excluded from analysis; nine had incompletely filled proforma, while seven were lost to follow-up.
Intraoperative blood loss.
The mean intraoperative blood loss was not significantly different between the misoprostol group and the tranexamic acid group (547 ± 183.75ml vs. 551.66 ± 21.74ml, P = 0.157). The mean difference in pack cell volume (PCV) changes was not significant between the groups (2.41±0.95% vs. 2.36±0.56%, P = 0.474). The side effects profile was similar for both groups except for shivering, which was statistically higher among the misoprostol group (RR = 0.70; 95%CI 0.40 - 0.91, P = 0.028).
Intravenous tranexamic acid was comparable to rectal misoprostol in the reduction of blood loss during C/S. Tranexamic acid could act as a good alternative to misoprostol for prophylaxis for blood loss during elective C/S.
None declared.
比较静脉注射氨甲环酸与直肠米索前列醇在减少剖宫产术中失血量的效果。
在尼日利亚阿巴卡利基的亚历克斯·埃克韦姆联邦大学教学医院进行的一项涉及接受选择性剖宫产术的孕妇的随机对照研究。
将 514 名接受择期剖宫产术的孕妇随机分配（每组 257 名患者），分别在脊髓麻醉后接受术前直肠米索前列醇 1000μg 或静脉注射氨甲环酸 1000mg。对米索前列醇组的 248 名患者和氨甲环酸组的 250 名患者进行了数据分析。有 16 名患者被排除在分析之外；9 名患者的表格填写不完整，7 名患者失访。
术中失血量。
米索前列醇组和氨甲环酸组的术中平均失血量无显著差异（547±183.75ml 比 551.66±21.74ml，P=0.157）。两组之间的红细胞压积（PCV）变化的平均差异无统计学意义（2.41±0.95%比 2.36±0.56%，P=0.474）。两组的副作用谱相似，除了米索前列醇组的寒战发生率较高外（RR=0.70；95%CI 0.40-0.91，P=0.028）。
在剖宫产术中减少失血量方面，静脉注射氨甲环酸与直肠米索前列醇相当。氨甲环酸可以作为预防选择性剖宫产术中失血的米索前列醇的良好替代品。
无。
