Meta-analysis of Clinical Efficacy and Safety of Misoprostol versus Oxytocin in Preventing Postpartum Hemorrhage
- VernacularTitle:米索前列醇对比缩宫素预防产后出血的临床有效性及安全性的Meta分析
- Author:
Weizheng DONG
1
;
Min DONG
2
;
Haiyan CHEN
1
;
Mengyan XU
3
Author Information
1. Dept. of Pharmacy，Hangzhou Linping District Hospital of Integrated Chinese and Western Medicine，Hangzhou 311199，China
2. Physical Examination Center，Hangzhou Linping District Hospital of Integrated Chinese and Western Medicine，Hangzhou 311199，China
3. Dept. of Nursing，Hangzhou Obstetrics and Gynecology Hospital，Hangzhou 310016，China
- Publication Type:Journal Article
- Keywords:
Misoprostol;
Oxytocin;
Postpartum hemor-
- From:
China Pharmacy
2021;32(21):2655-2661
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE：To systematically evaluate the c linical efficacy and safety of misoprostol versus oxytocin in preventing postpartum hemorrhage ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from CNKI，VIP，Wanfang database ，CBM，PubMed，Embase and the Cochrane Library ，randomized controlled trials （RCTs） published at home and abroad about clinical efficacy and safety of misoprostol and oxytocin in preventing postpartum hemorrhage were collected during the inception to Feb. 15th，2021. According to the inclusion and exclusion criteria ，the included studies were screened and evaluated. RevMan 5.3 software was used for Meta-analysis. RESULTS ：A total of 14 RCTs involving 25 732 lying-in women were included. The results of Meta-analysis showed that compared with oxytocin group ，there was no difference in the mean blood loss （MD＝14.96，95％CI（－2.62，32.54），P＝0.10），the time of the third stage of labor （MD＝－0.03，95％CI （－0.19，0.13），P＝0.69），the incidence of blood transfusion （RR＝0.91，95％CI（0.74，1.12），P＝0.37）or the incidence of nausea（RR＝1.06，95％CI（0.85，1.31），P＝0.60）in misoprostol group ；but the incidence of shivering（RR＝2.99，95％CI （2.22，4.04），P＜0.000 01），the incidence of fever （RR＝4.31，95％CI（2.79，6.67），P＜0.000 01），the incidence of vomiting （RR＝2.16，95％CI（1.63，2.88），P＜0.000 01）and the incidence of diarrhea （RR＝2.67，95％CI（1.79，3.98），P＜0.000 01）in misoprostol group were higher. CONCLUSIONS ：The effect of misoprostol in the prevention of postpartum hemorrhage is similar to oxytocin ，but the incidence of ADR is higher. It is necessary to pay close attention to the adverse reactions during use. Due to the limitation of included studies ，multi-center，large-scale and high-quality RCTs are needed for further validation.
