卡前列甲酯栓阴道给药、舌下含服预防产后出血

PREVENTING OF POSTPARTUM HAEMORRHAGE BY CARBOPROST METHYLATE SUPPOSITORY ADMINISTERED THROUGH VAGINA OR SUBSLINGUALLY

目的观察卡前列甲酯栓（卡孕栓）对产后出血发生的影响及其副作用。方法将正常足月妊娠阴道分娩者８０例随机分成３组，其中２组为卡孕栓实验组，以不同给药途径分为阴道用药组（２５例）与舌下含服组（２５例），对照组（３０例）则常规静脉推注麦角新碱。结果３组产妇的第３产程平均时间分别是７．６４、５．５２和６．４４ｍｉｎ，无明显统计学差异（Ｐ＞０．０５）；产后２ｈ内的平均出血量，对照组（２６０．８３ｍｌ）与卡孕栓阴道给药组（１９０．２８ｍｌ）及舌下含服组（１９９．８０ｍｌ）相比均有显著差异（Ｐ＜０．００１）；两卡孕栓组间则未见差异。两实验组产妇均未发生明显副反应。结论卡孕栓预防产后出血的效果优于麦角新碱，其阴道用药及舌下含服都是有效给药途径。

URPOSE To assess the efficacy and the side effect of carboprost methylate suppository in preventing postpartum haemorrhage.METHODS Eighty consecutive cases of full term vaginal deliveries were randomly divided into three groups. Group Ⅰ (25 cases) was administered 1mg of carboprost methylate suppository through vagina right after the delivery, Group Ⅱ (25 cases) also accepted 1mg of carboprost methylate suppository sublingually as soon as fetus head crowning, and Group Ⅲ (30 cases), as a control, was given 0.2mg of ergometrium intravenously immediately after the delivery of the fetus anterior shoulder. The time course of the third stage of the labour, the blood loss within two hours after the delivery, and the side effect were observed.RESULTS The mean time of the third stage was 7.64 in Group Ⅰ, 5.52 in Group Ⅱ, and 6.64min in Group Ⅲ, no significant difference was found (P>0.05). The blood loss volumn (mean value) of Group Ⅲ was 260.38ml, showing significant difference (P<0.001) compared with that of Group Ⅰ (190.28ml) and Group Ⅱ (199.80ml). There was no statistical difference between the latter two groups (P>0.05). No blood pressure fluctuation and adverse side effects were found after the administration of carboprost methylate suppository.CONCLUSIONS Carboprost methylate suppository is more effective in preventing postpartum uterine haemorrhage than ergometrium. Noticeably, the sublingual administration of the suppository is a facile and efficient pathway.