几内亚比绍一家一级保健中心进行的有关舌下含服米索前列醇治疗产后大出血的随机双盲临床试验

作     者：H.j L. Cardoso P. Nielsen B.B. 丁福 

作者机构：Department of Obstetrics Aarhus University Hospital 8200 Aarhus N Denmark 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第2期

页      面：2-3页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：舌下含服 保健中心 随机双盲 安慰剂对照 阴道分娩 出血发生率 平均失血量 产后出血 血红蛋白浓度 

摘      要：Objective: To evaluate whether routine administration of sublingual misoprostol 600 μg after delivery reduces postpartum haemorrhage. Design: Randomised double blind placebo controlled trial. Setting: Primary health centre in Bissau, Guinea-Bissau, West Africa. Participants: 661 women undergoing vaginal delivery. Intervention: Misoprostol 600 μg or placebo administered sublingually immediately after delivery. Main outcome measures: Postpartum haemorrhage, defined as a loss of ≥500 ml and decrease in haemoglobin concentration after delivery. Results: The incidence of postpartum haemorrhage was not significantly different between the two groups, the relative risk being 0.89 (95%confidence interval 0.76 to 1.04) in the misoprostol group compared with the placebo group. Mean blood loss was 10.5%(-0.5%to 20.4%)-lower in the misoprostol group than in the control group. Severe postpartum haemorrhage of ≥1000 ml or ≥1500 ml occurred in 17%(56) and 8%(25) in the placebo group and 11%(37) and 2%(7) in the misoprostol group. Significantly fewer women in the misoprostol group experienced alossof ≥1000 ml (0.66, 0.45 to 0.98) or ≥1500 ml (0.28, 0.12 to 0.64). The decrease in haemoglobin concentration tended to be less in the misoprostol group, the mean difference between the two groups being 0.16 mmol/l (-0.01 mmol/1 to 0.32 mmol/l). Conclusion: Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.