Comparative Study of the Efficacy of Misoprostol and Oxytocin Im in the Prevention of Post-Partum haemorrhage in a Low-Resource Setting  

作　　者：De-Joseph Kakisingi Mibi Olivier Nyakio Éloge Ilunga Mbaya Dieudonné Kakusu Marie Constance Nguru Musese Julien Bwama Botalatala Omari Mukanga Tina Ndala Kasongo Gabrio Zacchè Dieudonné Sengeyi Mushengezi Amani Mary T. White Mary Joséphine O’Sullivan De-Joseph Kakisingi Mibi;Olivier Nyakio;Éloge Ilunga Mbaya;Dieudonné Kakusu;Marie Constance Nguru Musese;Julien Bwama Botalatala;Omari Mukanga;Tina Ndala Kasongo;Gabrio Zacchè;Dieudonné Sengeyi Mushengezi Amani;Mary T. White;Mary Joséphine O’Sullivan(Department of Gynecology, and Obstetrics, Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo;Departement of Medicine and Public Health, Evangelical University in Africa, Bukavu, Democratic Republic of the Congo;Department of Gynecology and Obstetrics, University of Kinshasa, Kinshasa, Democratic Republic of the Congo;Department of Statistics, Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo;Saint Vincent Hospital, Bukavu, Democratic Republic of the Congo;Department of Medicine and Surgery, University of Parma, Parma, Italy;Medical Humanities, Boonschoft School of Medicine, Wright State University, Dayton, USA;School of Nursing & Health Studies, University of Miami, Coral-Gable, USA)

机构地区：[1]Department of Gynecology, and Obstetrics, Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo [2]Departement of Medicine and Public Health, Evangelical University in Africa, Bukavu, Democratic Republic of the Congo [3]Department of Gynecology and Obstetrics, University of Kinshasa, Kinshasa, Democratic Republic of the Congo [4]Department of Statistics, Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo [5]Saint Vincent Hospital, Bukavu, Democratic Republic of the Congo [6]Department of Medicine and Surgery, University of Parma, Parma, Italy [7]Medical Humanities, Boonschoft School of Medicine, Wright State University, Dayton, USA [8]School of Nursing & Health Studies, University of Miami, Coral-Gable, USA

出　　处：《Open Journal of Obstetrics and Gynecology》2023年第5期983-996,共14页妇产科期刊（英文）

摘　　要：Background: In developing countries, postpartum hemorrhage is responsible for 30% of maternal deaths. Although the World Health Organization recommends the use of oxytocin for the prevention of postpartum hemorrhage, the use of misoprostol is increasingly common. The objective of this study was to determine the frequency of postpartum hemorrhage in parturients delivering at Saint-Vincent Hospital and to compare the effectiveness of misoprostol use versus oxytocin in preventing postpartum hemorrhage. Material and Methods: We conducted a comparative longitudinal study at the Saint Vincent Hospital comparing 10 units of intramuscular oxytocin with 600 micrograms of sublingual misoprostol. The study was conducted from 01 January 2017 to 31 December 2019, a period of 3 years. The study population consisted of 2161 consenting women. Of these, 1289 received 10 IU of intramuscular oxytocin and 872 received 600 micrograms of misoprostol. The collected data were entered using Microsoft Excel 2013 and analysed using SPSS version 21 software. Results: The frequency of administration of Misoprostol and oxytocin in parturients was 40.4% and 59.6% respectively in this study. One hundred and fourteen cases of postpartum hemorrhage (114/2161 or 5.3%) were noted among the parturients. The average age of parturients who received oxytocin was 24.36 ± 4.45 years vs 24.63 ± 5.11 years among parturients who received Misoprostol;(p = 0.190). The mean parity was 2.52 ± 1.46 vs 2.66 ± 1.44;(p = 0.020). We noted a high proportion (78.3%) of postpartum hemorrhage from the oxytocin group vs. 21.7% from the Misoprostol group (OR 2.5-fold), with a statistically significant difference (p 0.001). We noted high proportions of uterine atony (92.3%) from the oxytocin group vs 7.7% from the Misoprostol group (p = 0.004). Uterine atony was the actual factor associated with postpartum hemorrhage (OR = 10.0895% CI: 1.78 - 57.10;p = 0.009). Conclusion: Misoprostol 600 Microgram administered sublingually immediately after neonatal expulsion and beforBackground: In developing countries, postpartum hemorrhage is responsible for 30% of maternal deaths. Although the World Health Organization recommends the use of oxytocin for the prevention of postpartum hemorrhage, the use of misoprostol is increasingly common. The objective of this study was to determine the frequency of postpartum hemorrhage in parturients delivering at Saint-Vincent Hospital and to compare the effectiveness of misoprostol use versus oxytocin in preventing postpartum hemorrhage. Material and Methods: We conducted a comparative longitudinal study at the Saint Vincent Hospital comparing 10 units of intramuscular oxytocin with 600 micrograms of sublingual misoprostol. The study was conducted from 01 January 2017 to 31 December 2019, a period of 3 years. The study population consisted of 2161 consenting women. Of these, 1289 received 10 IU of intramuscular oxytocin and 872 received 600 micrograms of misoprostol. The collected data were entered using Microsoft Excel 2013 and analysed using SPSS version 21 software. Results: The frequency of administration of Misoprostol and oxytocin in parturients was 40.4% and 59.6% respectively in this study. One hundred and fourteen cases of postpartum hemorrhage (114/2161 or 5.3%) were noted among the parturients. The average age of parturients who received oxytocin was 24.36 ± 4.45 years vs 24.63 ± 5.11 years among parturients who received Misoprostol;(p = 0.190). The mean parity was 2.52 ± 1.46 vs 2.66 ± 1.44;(p = 0.020). We noted a high proportion (78.3%) of postpartum hemorrhage from the oxytocin group vs. 21.7% from the Misoprostol group (OR 2.5-fold), with a statistically significant difference (p 0.001). We noted high proportions of uterine atony (92.3%) from the oxytocin group vs 7.7% from the Misoprostol group (p = 0.004). Uterine atony was the actual factor associated with postpartum hemorrhage (OR = 10.0895% CI: 1.78 - 57.10;p = 0.009). Conclusion: Misoprostol 600 Microgram administered sublingually immediately after neonatal expulsion and befor

关 键 词：MISOPROSTOL OXYTOCIN Postpartum Hemorrhage Saint-Vincent Hospital 

分 类 号：R16[医药卫生—公共卫生与预防医学]