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目的探讨米索前列醇预防产妇产后出血的临床疗效。方法选取2014年1月至2015年1月在大连市沙河口区妇幼保健院分娩并伴有产后出血高危因素的孕妇80例为研究对象,按照出血预防方式不同随机分为观察组与对照组,每组40例。观察组产妇在胎前肩娩出后立即给予口服米索前列醇400μg,对照组产妇在胎前肩娩出后即静脉注射10%葡萄糖注射液20 ml+缩宫素20 U。采用估算法、容积法、称重法联合测量出血量,比较两组产妇出血情况、第三产程时间及产后出血发生率。结果观察组1例发生产后出血,出血发生率为2.5%,产后2 h出血量为(169±44)ml,产后24 h出血量为(211±58)ml,第三产程时间为(7.0±1.2)min;对照组4例发生产后出血,出血发生率为10.0%,产后2 h出血量为(213±54)ml,产后24 h出血量为(292±77)ml,第三产程时间为(9.1±1.7)min。观察组产后出血发生率、产后2 h及24 h出血量和第三产程时间均明显小于对照组,差异均有统计学意义(均P<0.05)。结论对于存在产后出血高危因素的产妇在胎前肩娩出后立即给予米索前列醇可明显降低产后出血的发生率,减少出血量,缩短第三产程时间。
Objective To investigate the clinical efficacy of misoprostol in preventing postpartum hemorrhage. Methods From January 2014 to January 2015, 80 pregnant women with maternal risk factors for postpartum hemorrhage in Shahekou Maternal and Child Health Hospital of Dalian were enrolled in this study. The patients were randomly divided into observation group and control group Group of 40 cases. In the observation group, 400 μg oral misoprostol was given to the maternal of the anterior fetal shoulder immediately. The control group received intravenous injection of 20 ml of 10% glucose and 20 U of oxytocin intravenously once the anterior fetal shoulder was delivered. The blood loss was measured by the method of estimation, volumetric method and weighing method. The maternal hemorrhage, the time of the third stage of labor and the incidence of postpartum hemorrhage were compared. Results The incidence of postpartum hemorrhage was 2.5% in 1 case of observation group, 169 ± 44 ml in 2 h postpartum, 211 ± 58 ml in 24 h postpartum, and 7.0 ± 1.2) min. In the control group, 4 cases had postpartum hemorrhage, the incidence of hemorrhage was 10.0%, the amount of hemorrhage was (213 ± 54) ml at 2 h postpartum and the hemorrhage amount was (292 ± 77) (9.1 ± 1.7) min. The incidence of postpartum hemorrhage in the observation group was significantly lower than that in the control group at 2 h and 24 h postpartum (all P <0.05). Conclusions Maternal exposure to high risk factors for postpartum hemorrhage immediately after delivery of misoprostol can significantly reduce the incidence of postpartum hemorrhage, reduce the amount of bleeding and shorten the third stage of labor.