Oral misoprostol for the third stage of labor:: A randomized controlled trial

被引:46
作者
Çaliskan, E [1 ]
Dilbaz, B [1 ]
Meydanli, MM [1 ]
Öztürk, N [1 ]
Narin, MA [1 ]
Haberal, A [1 ]
机构
[1] SSK Matern & Womens Hlth Teaching Hosp, Ankara, Turkey
关键词
D O I
10.1016/S0029-7844(03)00077-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: To compare oral misoprostol with conventional oxytocics in the management of,the third stage of labor. METHODS: In a controlled trial, 1574 women were randomized into four groups, as follows: Group 1 received intravenous infusion of oxytocin 10 IU plus oral misoprostol 400 mug, followed by two doses of oral misoprostol 100 mug 4 hours apart; group 2 received oral misoprostol 400 mug, followed by two doses of oral misoprostol 100 mug 4 hours apart; group 3 received intravenous infusion of oxytocin 10 IU; and group 4 received intravenous infusion of oxytocin 10 IU plus intramuscular administration of methylergonovine maleate (Methergine) 0.2 mg. The incidence of postpartum hemorrhage and decrease in hemoglobin concentration from before delivery to 24 hours postpartum were the main outcome measures. RESULTS: The primary outcome measures were similar in groups 2 and 3. The incidence of postpartum hemorrhage was 9% in group 2, compared with 3.2% in group 1 and 3.5% in group 4 (P < .01, and P = .01, respectively). There were no significant differences among the four groups regarding hemoglobin concentrations. Significantly more women needed additional oxytocin in group 2, when compared with group 4 (5.9% versus 2.2%; P = .01). The proportion of women requiring additional methylergonovine maleate was 4.8% in group 2, compared with 0.7% in group 1 and 1% in group 4 (P < .01 and P = .01, respectively). CONCLUSION: Oral misoprostol alone is as effective as oxytocin alone for the prevention of postpartum hemorrhage; it is less effective than oxytocin plus methylergonovine maleate and oral misoprostol plus oxytocin. (Obstet Gynecol 2003;101:921-8. (C) 2003 by The American College of Obstetricians and Gynecologists).
引用
收藏
页码:921 / 928
页数:8
相关论文
共 17 条
[11]   ANTIULCER PROSTAGLANDIN MISOPROSTOL - SINGLE AND MULTIPLE DOSE PHARMACOKINETIC PROFILE [J].
KARIM, A .
PROSTAGLANDINS, 1987, 33 :40-50
[12]   THE EFFECTS OF ROUTINE OXYTOCIC ADMINISTRATION IN THE MANAGEMENT OF THE 3RD STAGE OF LABOR - AN OVERVIEW OF THE EVIDENCE FROM CONTROLLED TRIALS [J].
PRENDIVILLE, W ;
ELBOURNE, D ;
CHALMERS, I .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1988, 95 (01) :3-16
[13]  
PRITCHARD JA, 1962, AM J OBSTET GYNECOL, V84, P1271
[14]   Oral misoprostol for third stage of labor:: A randomized placebo-controlled trial [J].
Surbek, DV ;
Fehr, PM ;
Hösli, I ;
Holzgreve, W .
OBSTETRICS AND GYNECOLOGY, 1999, 94 (02) :255-258
[15]   A double-blind placebo controlled randomised trial of misoprostol and oxytocin in the management of the third stage of labour [J].
Walley, RL ;
Wilson, JB ;
Crane, JMG ;
Matthews, K ;
Sawyer, E ;
Hutchens, D .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2000, 107 (09) :1111-1115
[16]  
*WHO, 1991, MAT MORT GLOB FACTB, P7
[17]   Absorption kinetics of misoprostol with oral or vaginal administration [J].
Zieman, M ;
Fong, SK ;
Benowitz, NL ;
Banskter, D ;
Darney, PD .
OBSTETRICS AND GYNECOLOGY, 1997, 90 (01) :88-92