Background: Blood loss is one of the important complications during cesarean section (CS). Previous reports have shown that misoprostol is effective in reducing blood loss during and after CS. However, the optimum tim...Background: Blood loss is one of the important complications during cesarean section (CS). Previous reports have shown that misoprostol is effective in reducing blood loss during and after CS. However, the optimum time for its administration to decrease the amount of PPH is still under discussion. Objective: To compare the effect of preoperative and postoperative administration of sublingual misoprostol (400 μg) in reducing the amount of blood loss during and 24 hours after CS. Setting: Obstetrics and Gynecology Department, Faculty of Medicine, Assiut University, Assiut, Egypt, between January 2017 and July 2018. Study Design: A prospective, randomized clinical trial. Methods: Four-hundred thirty women fulfilling the inclusions criteria: elective lower segment CS at term (≥37 weeks) with normal fetal heart tracing who accepted to participate in the study. Patients were divided into two groups;Patients assigned to group 1 received 400 μg sublingual misoprostol immediately after urinary catheterization and before skin incision, while patients assigned to group 2 received sublingual misoprostol immediately after skin closure. The primary outcome was the estimation of intraoperative and postoperative blood loss for 24 hours. Results: There was a significant reduction in the intraoperative blood loss in group 1 compared with group 2 (403.51 ± 72.99 vs. 460.99 ± 74.66 ml, respectively). Also, there was a significant reduction in postoperative blood loss in group 1 compared with group 2 with a statistical significance (169.45 ± 12.03 vs. 195.77 ± 13.34 ml, respectively). Postoperative hemoglobin and Hematocrit values were significantly higher in group 1 compared with group 2. Conclusions: Preoperative administration of sublingual misoprostol (400 μg) during CS is better than postoperative administration as it is associated with a reduction in the amount of intraoperative and postoperative blood loss and drop in hemoglobin level.展开更多
目的观察三种宫缩药物(卡前列甲酯栓,米索前列醇,缩宫素)预防高危产妇剖宫产术中及术后出血的疗效。方法选择有产后出血倾向的高危孕妇240例,按随机数字表法分为3组:卡前列甲酯栓组(n=80),娩出胎儿后立即缩宫素20 I U静脉滴注+卡前列甲...目的观察三种宫缩药物(卡前列甲酯栓,米索前列醇,缩宫素)预防高危产妇剖宫产术中及术后出血的疗效。方法选择有产后出血倾向的高危孕妇240例,按随机数字表法分为3组:卡前列甲酯栓组(n=80),娩出胎儿后立即缩宫素20 I U静脉滴注+卡前列甲酯栓1 mg舌下含服;米索前列醇组(n=80),胎儿娩出后缩宫素20 I U静脉滴注+缩宫素20 I U宫体注射+米索前列醇600μg塞肛;缩宫素组(n=80),胎儿娩出后缩宫素20 I U静脉滴注+缩宫素20 I U宫体注射。计算三组术中出血量及产后24 h出血量,比较3种宫缩剂的疗效。结果缩宫素组产后24 h出血量、产后出血发生率及产后24 h血红蛋白平均下降值明显高于卡前列甲酯栓组和米索前列醇组(P<0.05),差异有统计学意义。卡前列甲酯栓组与米索前列醇组经比较,差异无统计学意义(P>0.05)。结论卡前列甲酯栓、米索前列醇用于有产后出血倾向的产妇,可明显减少剖宫产术中及术后出血量,其效果优于缩宫素,且具有安全、高效、迅速、价廉、方便等优点。展开更多
文摘Background: Blood loss is one of the important complications during cesarean section (CS). Previous reports have shown that misoprostol is effective in reducing blood loss during and after CS. However, the optimum time for its administration to decrease the amount of PPH is still under discussion. Objective: To compare the effect of preoperative and postoperative administration of sublingual misoprostol (400 μg) in reducing the amount of blood loss during and 24 hours after CS. Setting: Obstetrics and Gynecology Department, Faculty of Medicine, Assiut University, Assiut, Egypt, between January 2017 and July 2018. Study Design: A prospective, randomized clinical trial. Methods: Four-hundred thirty women fulfilling the inclusions criteria: elective lower segment CS at term (≥37 weeks) with normal fetal heart tracing who accepted to participate in the study. Patients were divided into two groups;Patients assigned to group 1 received 400 μg sublingual misoprostol immediately after urinary catheterization and before skin incision, while patients assigned to group 2 received sublingual misoprostol immediately after skin closure. The primary outcome was the estimation of intraoperative and postoperative blood loss for 24 hours. Results: There was a significant reduction in the intraoperative blood loss in group 1 compared with group 2 (403.51 ± 72.99 vs. 460.99 ± 74.66 ml, respectively). Also, there was a significant reduction in postoperative blood loss in group 1 compared with group 2 with a statistical significance (169.45 ± 12.03 vs. 195.77 ± 13.34 ml, respectively). Postoperative hemoglobin and Hematocrit values were significantly higher in group 1 compared with group 2. Conclusions: Preoperative administration of sublingual misoprostol (400 μg) during CS is better than postoperative administration as it is associated with a reduction in the amount of intraoperative and postoperative blood loss and drop in hemoglobin level.
文摘目的观察三种宫缩药物(卡前列甲酯栓,米索前列醇,缩宫素)预防高危产妇剖宫产术中及术后出血的疗效。方法选择有产后出血倾向的高危孕妇240例,按随机数字表法分为3组:卡前列甲酯栓组(n=80),娩出胎儿后立即缩宫素20 I U静脉滴注+卡前列甲酯栓1 mg舌下含服;米索前列醇组(n=80),胎儿娩出后缩宫素20 I U静脉滴注+缩宫素20 I U宫体注射+米索前列醇600μg塞肛;缩宫素组(n=80),胎儿娩出后缩宫素20 I U静脉滴注+缩宫素20 I U宫体注射。计算三组术中出血量及产后24 h出血量,比较3种宫缩剂的疗效。结果缩宫素组产后24 h出血量、产后出血发生率及产后24 h血红蛋白平均下降值明显高于卡前列甲酯栓组和米索前列醇组(P<0.05),差异有统计学意义。卡前列甲酯栓组与米索前列醇组经比较,差异无统计学意义(P>0.05)。结论卡前列甲酯栓、米索前列醇用于有产后出血倾向的产妇,可明显减少剖宫产术中及术后出血量,其效果优于缩宫素,且具有安全、高效、迅速、价廉、方便等优点。
