Van Selm M, Kanhai H H, Keirse M J
Department of Obstetrics, Gynaecology, and Reproduction, Leiden University Hospital, The Netherlands.
Acta Obstet Gynecol Scand. 1995 Apr;74(4):270-4. doi: 10.3109/00016349509024448.
We conducted a double-blind randomized controlled trial to compare a conventional regimen of oxytocin and ergometrine with administration of the prostaglandin E2 analogue, sulprostone, for prophylaxis of postpartum hemorrhage in high-risk women.
Women with a history of postpartum hemorrhage > or = 1000 were assigned to two coded prophylactic regimens. Drugs, given respectively at delivery of the anterior shoulder and after delivery of the placenta, were oxytocin and ergometrine in the control group, and sulprostone and placebo in the experimental group. Eighty-one women, 69 of whom actually participated in the trial, were investigated. Both the women and the caregivers were unaware of treatment allocation.
Although the trial was terminated prematurely there was a slight, but not statistically significant, preference for the sulprostone regimen in terms of blood loss and use of blood transfusion. No serious adverse effects were noted with either of the two regimens.
Prostaglandins may be more effective for preventing recurrence of severe postpartum hemorrhage than the oxytocin and ergometrine combination, but they do not eliminate the risk entirely.
我们进行了一项双盲随机对照试验，以比较催产素和麦角新碱的传统方案与前列腺素E2类似物磺前列酮用于预防高危女性产后出血的效果。
有产后出血史≥1000的女性被分配到两种编码的预防方案中。对照组在娩出前肩时和胎盘娩出后分别给予催产素和麦角新碱，试验组给予磺前列酮和安慰剂。共调查了81名女性，其中69名实际参与了试验。女性和护理人员均不知道治疗分配情况。
尽管试验提前终止，但在失血和输血使用方面，对磺前列酮方案有轻微但无统计学意义的偏好。两种方案均未观察到严重不良反应。
前列腺素在预防严重产后出血复发方面可能比催产素和麦角新碱联合用药更有效，但它们并不能完全消除风险。
