Bruce S L, Paul R H, Van Dorsten J P
Obstet Gynecol. 1982 Jun;59(6 Suppl):47S-50S.
Five patients with severe postpartum hemorrhage due to uterine atony and unresponsive to oxytocin, ergonovine, and massage were treated with intramyometrial injection of 250 micrograms of prostaglandin (15S)-15-methyl PGF2 alpha-Tham. Four patients received 2 injections (500 micrograms), and 1 patient required 1 injection (250 micrograms). Three (60%) of 5 patients responded successfully with an increase in uterine tone and cessation of uterine hemorrhage, thus obviating the need for hysterectomy. Two patients had no uterine response, possibly because of delayed use of the drug, excessive blood loss, and accompanying shock; they required hysterectomy. Intramyometrial injection of prostaglandin is an effective and safe method of managing severe postpartum hemorrhage unresponsive to oxytocin and ergonovine, but it must be used early during the management of atony to obtain maximum effect. This method should precede surgical management of uterine atony.
5例因子宫收缩乏力导致严重产后出血且对催产素、麦角新碱及按摩均无反应的患者，接受了子宫肌层内注射250微克前列腺素（15S）-15-甲基前列腺素F2α-氨丁三醇治疗。4例患者接受了2次注射（500微克），1例患者仅需1次注射（250微克）。5例患者中有3例（60%）成功出现子宫张力增加及子宫出血停止的反应，从而避免了子宫切除术。2例患者未出现子宫反应，可能是由于药物使用延迟、失血过多及并发休克所致；她们需要接受子宫切除术。子宫肌层内注射前列腺素是治疗对催产素和麦角新碱无反应的严重产后出血的一种有效且安全的方法，但必须在处理子宫收缩乏力的早期使用才能获得最大效果。该方法应在子宫收缩乏力的手术处理之前应用。
