Çağlar Çetin, Hanife Rana Dural, Pınar Özcan, Fatma Başak Tanoğlu, Mehmet Serdar Kütük, Özge Pasin, Seda Ateş
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The primary outcome measures were: PPH to evaluate with the change between the concentrations of preoperative and postoperative hemoglobin, hematocrit and intraoperative blood loss.</p><p><strong>Results: </strong>The blood loss characteristics, including the change in hemoglobin and the change in hematocrit concentration, intraoperative blood loss, intraoperative additional hemostatic uterine sutures and the need for additional uterotonics, were lowest in group III, although all groups were comparable in terms of blood loss parameters. Group III had the highest blood loss ratio, exceeding 1000 mL. 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引用次数: 0
摘要
目的:在我们的随机对照试验中,比较三种方案的子宫扩张药物对剖宫产妇女PPH的疗效。材料和方法:本研究是一项随机对照研究(NCT05083910),于2021年7月至2022年1月在Bezmialem Vakif大学进行。所有女性随机分为三组:第一组(n = 52) -仅使用催产素;II组(n = 52)——催产素联合宫内米索前列醇;III组(n = 52)仅使用卡贝霉素。主要观察指标为:PPH与术前、术后血红蛋白浓度、红细胞压积及术中出血量的变化。结果:出血量特征,包括血红蛋白和红细胞压积浓度的变化、术中出血量、术中额外止血子宫缝合和需要额外子宫强张,III组最低,尽管所有组在出血量参数方面具有可比性。第三组出血率最高,超过1000 mL。催产素联合宫内米索前列醇的ARR为3.8% (95% CI 20.02-12.33), RR为1.18 (95% CI 0.58-2.39), NNT为26 (95% CI 8.1-4.9);卡霉素的ARR为5.8% (95% CI 22.15-10.61), RR为1.27 (95% CI 0.63-2.53), NNT为17 (95% CI 9.41-4.51)。结论:我们的研究结果表明,卡贝霉素在预防剖宫产妇女PPH方面没有优势。催产素似乎仍然是预防PPH的一种非常有效的选择。
The efficacy of three regimes of uterotonic agents for prevention of postpartum blood loss at undergoing cesarean section: a prospective randomized clinical trial.
Objectives: To compare the efficacy of three regimes of uterotonic agents on PPH in women undergoing cesarean section in our RCT.
Material and methods: This study was a randomized controlled study (NCT05083910) performed at the Bezmialem Vakif University between July 2021 and January 2022. All women were randomly allocated into three groups: Group I (n = 52) - oxytocin only; Group II (n = 52) - the combination of oxytocin plus intrauterine misoprostol; Group III (n = 52) - carbetocin only. The primary outcome measures were: PPH to evaluate with the change between the concentrations of preoperative and postoperative hemoglobin, hematocrit and intraoperative blood loss.
Results: The blood loss characteristics, including the change in hemoglobin and the change in hematocrit concentration, intraoperative blood loss, intraoperative additional hemostatic uterine sutures and the need for additional uterotonics, were lowest in group III, although all groups were comparable in terms of blood loss parameters. Group III had the highest blood loss ratio, exceeding 1000 mL. For the combination of oxytocin and intrauterine misoprostol, the ARR was 3.8% (95% CI 20.02-12.33), with a RR of 1.18 (95% CI 0.58-2.39) and a NNT of 26 (95% CI 8.1-4.9); for carbetocin, the ARR was 5.8% (95% CI 22.15-10.61), with a RR of 1.27 (95% CI 0.63-2.53) and a NNT of 17 (95% CI 9.41-4.51).
Conclusions: Our results demonstrate that carbetocin shows no superiority in the prevention of PPH in women undergoing cesarean section. Oxytocin still seems to be a highly effective alternative to prevent PPH.
期刊介绍:
Ginekologia Polska’ is a monthly medical journal published in Polish and English language.
‘Ginekologia Polska’ will accept submissions relating to any aspect of gynaecology, obstetrics and areas directly related. ‘Ginekologia Polska’ publishes original contributions, comparative works, case studies, letters to the editor and many other categories of articles.