Buradasınız

Anasayfa » Content

MİSOPROSTOL İLE OKSİTOSİN VE METİLERGOBASİN MALEAT KULLANIMININ DOĞUMUN ÜÇÜNCÜ DÖNEMİNİN SÜRESİNE VE KAN KAYBINA OLAN ETKİLERİNİN KARŞILAŞTIRILMASI

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
The comparison of the effects of mysoprostole (800 mcg/PO) or oxytosine 10 IU/IM. plus methylergobacine maleate (200 mg/IM) administered in the third stage of labor on the duration of the stage and blood loss. Design.- Seventy pregnants admitted to department of Obstetrics and Gynecology were randomly selected to this prospective and single blind study program. Right after labor, umblical cord was clamped and mysoprostole 800 mcg/PO were administered to the individuals in the study group (group 1) and oxytosine 10 IU plus methylergobacine maleate 200 mcg/IM in the control group (group 2). The parameters relating the third stage blood loss before and after the delivery of placenta; the duration of third stage was monitored. The monitoring of the side effects has been done by checking body temperature, shivering, noisea – vomiting, diarrhea, blood pressure every hour for the first day after the cord was clamped. Body temperatures over 38 0C were accepted meaningful (<38 0C=0 p, >38 0C=1p) and nominal scale was employed for the alterations in noisea – vomiting, diarrhea (absent=0p, present=1p) and blood pressure (systolic>150 mmHg, diastolic>100 mmHg=1p, if both below the given values=0p). Results.- Study was accomplished in 66 patients. Blood loss after the delivery of placenta was found to be 57±6 ml in group 1, whereas it was 161±87 ml in group 2 (p<0.001, Student t test). The duration of the third stage of labor was found as 5.7±1.5 min in group 1, whereas it was 18±5 min in group 2 (p<0.001, Student’s t test). Body temperature elevations were encountered in all 33 cases (100%) in group 1 and in 4 cases (12%) in group 2 (RR=8, p<0.001, Fisher’s exact test). Shivering was found in 33 cases (100%) in group 1 and in 9 cases (27%) in group 2. (RR=3.7, p=0.001, Fisher’s exact test). Total blood loss was below 500 ml in 31 cases (93%) in group 1 and in 23 cases (70%) in group 2 (RR=1.3, p<0.001, Fisher’s exact test). Conclusion.- In contrary to oxytosine plus methergine, mysoprostole administered in the third stage of labor, diminishes the duration of third stage and blood loss, as well as elevates the body temperature and promotes shivering. But it may well be an alternative to oxytosine plus methergine due to blood loss decreasing effect and the ease in its storage and application.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Doğumun üçüncü döneminde kullan ılan 800 mcg misoprostol/PO ile 10 IÜ oksitosin ve 200mcg metilergobasin maleat/IM’in doğumun üçüncü döneminin süresine ve kan kaybı üzerine olan etkilerinin karşılaştırılması. Yöntem ve Gereçler: Fırat Üniversitesi Tıp Fakültesi Kadın Doğum Bölümüne başvuran 70 gebe randomize prospektif, tek kör çalışma programına alındı. Bebek doğurtulduktan sonra kord klemplendi ve çalışma grubundakilere (G1) 800 mcg/PO misoprostol, kontrol grubundakilere (G2) 10 IÜ oksitosin ve 200 mcg metilergobasin maleat intramuskuler uygulandı. Doğumun üçüncü dönemine ait özellikler (kan kaybı: Plasentanın doğumundan önce (ml), doğumundan sonra (ml)), üçüncü dönemin sü- resi (dk), araştırıldı. Yan etkilerin değerlendirilmesi için ateş, titreme, bulantı, kusma, ishal, tansiyon arteryel takibi kord klemplemesinden sonra 24 saat boyunca her saat bakıldı. Ateşin 38 oC’ nin üzerinde olması anlamlı kabul edildi (Ateş<38 oC=0p; ateş>38 oC= 1p) ve ayrıca titreme, bulantı, kusma, ishal ve tansiyon arteryel değişiklikleri için (Sistolik >150 mmHg; diastolik >100 mm Hg=1p, küçükse =0p) de nominal skala (yok=0p,var=1p) oluşturuldu. Bulgular: Altmış altı vakada çalışma ger- çekleştirildi. Plasentanın doğumundan sonra görülen kan kaybı grup 1’de 57±6 ml iken grup 2’de 161±87 ml, doğumun üçüncü döneminin süresi grup 1’de 5.7±1.5 dk iken grup 2’de 18±5 dk bulundu (p=0.001, Student’s t testi). Ateş grup 1’de 33 vakada (%100) grup 2’de 4 vakada (%12) (RR=8, p=0.001, Fisher’s exact test), titreme grup 1’de 33 vakada (%100) grup 2’de 9 vakada (%27) görüldü (RR=3.7, p= 0.001, Fisher’s exact test). Toplam kan kaybı grup 1’de 31 vakada (%93) grup 2’de 23 vakada (%70) 500 cc’nin altında idi (RR=1.3, p= 0.001, Fisher’s exact test). Sonuç: Doğumun üçüncü döneminde 800 mcg/PO misoprostol kullanıldığında, doğumun üçüncü döneminin süresi, plasentanın doğumundan sonraki kan kaybı l0IÜ oksitosin ve 200 mcg/IM metilergobasin maleat’a göre anlaml ı olarak azalır. Ateş ve titremede ise anlaml ı artışa neden olur. Ancak gerek kan kayb ını azaltması, gerekse depolanma ve uygulama kolaylıkları nedeniyle oksitosin ve meterjin kullanımına seçenek olabilir.
FULL TEXT (PDF): 
PDF icon arastirmax-misoprostol-ile-oksitosin-metilergobasin-maleat-kullaniminin-dogumun-ucuncu-doneminin-suresine-kan-kaybina-olan-etkilerinin-karsilastirilmasi.pdf
  • 3
179-184
  • Turkish

REFERENCES

References: 

1. El-Refaey H, O’Brien P: Use of oral misoprostol in the
prevention of postpartum haemorrhage. Br J
Obstet.Gynaecol 1997; 104: 336-339.
2. McDonald S, Prendiville W, Blair E. Randomized
controlled trial of oxytocin alone versus oxytosin and
ergometrine in active management of third stage of
labour. Br J Obstet Gynaecol 1993; 307: 1167-1171.
3. Poeschmann R.P, Doesburg W.H, Eskes T.K.A.
Randomized comparison of oxytocin, sulprostone and
plasebo in the management of the third stage of labour.
Br J Obstet Gynaecol 1991; 98: 528-530.
4. Nordstöm L,Fogelstam K,Fridman G, Larsson A,
Rydhstroem H. Routine oxytocin in the third stage of
labour:A plasebo controlled randomised trial. Br. J.
Obstet. Gynaecol. 1997; l04: 781-786.
5. Prendiville W, Elbourne D, Chalmers I. The effect of
routine oxytocic administration in the management of the
third stage of labour: an overview of the evidence from
controlled trials. Br J Obstet Gynaecol 1988; 95: 3-16.
6. Beisner NA, Mackay EV. Obstetrics and the Newborn.
London:Bailliere Tindall,1986: 169-177.
7. Prendiville W, Elburne D. Care during the third stage of
labour. In: Chalmers I, Enkin M, Keirse MJNC, editors.
Effective Care in Pregnancy and Childbirth.Oxford:
Oxford University Press. 1989; 1145-1169.
8. Hogerzeil HV,Walker GJA; de Goeje MJ. Stability of
injectable Oxytocics in Tropical Climates. Geneva:World
Organization,1993.
9. Kararlõ TT, CatalanoT, Needham TE, Finnegan PM.
Mechanism of misoprostol stabilization in hydroxpropyl
methylcellulose. Adv. Exp. Med. Biol. 1991; 302: 145-
148.
10. Aubeny E, Baulieu EE. Activite contra gestivie de
l’association au RU486 D’une prostaglandine active par
voie’oral. C R Acad Sci III l991; 312: 539-546.
11. El-Rafaey H,Hinshaw K, Templeton A. The abortifacient
effect of misoprostol in the second trimester. Hum.
Reprod. 1993; 8: 1744-1746.
12. Karim A. Antiulcer prostoglandin misoprostol: single and
multiple dose pharmacokinetic profile. Prostoglandins
l987; 33: 40-50.
13. Norman JE, Thong KJ, Baird DT. Uterine contractility
and induction of abortion in early pregnancy by
misoprostol and mifepristone.Lancet l99l; 338: l233-
1236.
14. Brecht T. Effects of misoprostol on human circulation.
Prostoglandins1987; 33: 5l-59.
15. Pregnancy and childbirth Module. In: Keirse MJNC,
Renfrew MJ,Neilson JP,Crowther c, editors. Cochrane
Database of systematic Reviews. The Cochrane
Collaboration, Issue 2. Oxford:Update
software,1995:Review Nos 2974, 2999, 5352.
16. Prendiville Wl, Harding JE, Elbourne DR, Stirrat GM.
The Bristol third stage trial :active versus physiological
management of third stage of labour. Br J Obstet
Gynaecol. 1988; 297: 1295-1300.
17. Thilaganathan B, Cuter A, Latimer J, Beard R.
Management of the third stage of labour in women at low
risk of postpartum haemmorrhage. Eur. J. Obstet Gynecol
Reprod Biol 1993; 48: 19-22.
18. Ringrose CAD. The obstetrical use of ergot. Can Med.
Assoc. J. 1962; 87: 712-714.
19. Browning DJ. Serious side effects of ergometrine and its
use in routine obstetrics practice. Med. J. Austral 1974;
957-959.
20. Amant F, Bernard S, Timmerson D, Corremans A:
Misoprostol compared with methylergometrine for the
prevention of postpartum haemorrhage: adouble- blind
randomised trial: Br J Obstet Gynaecol 1999; 106: 1066-
1070.
21. Hofmeyr GJ, Nikodem VC, De Jager M, Gelbart B. A
randomised placebo controlled trial of oral misoprostol in
the third stage of labour. Br J Obstet Gynaecol 1998; 105:
971-975.
22. Bamigboye AA, Hofmeyr J, Merrell DA. Rectal
prevention of postpartum hemorrhage: A plasebocontrolled
trial. Am J Obstet Gynecol 1998; 179: 1043-
1046
23. O’Brien P, EL-Rafaey H, Gordon A, Geary M, Rodeck
CH: Rectally administered misoprostol for the treatment
of postpartum hemorrhage unresponsive to oxytocin and
ergometrine: a descriptive stydy. Obstet Gynecol 1998;
92: 212-214.
24. Lumbiganon P, Hofmeyr J, Gülmezoğlu A M, Pinol A,
Villar J. Misoprostol dose-related shivering and pyrexia
in the third stage of labour. Br J Obstet Gyneacol
1999;106: 304-308.
25. İnman WH. Report on curret PEM studies: Drugs for
peptic ulcer or reflux. Prescription Event Monitoring
News. 1991; 7:32-34.
26. Stobie-Hayes KM, Fewell JE. İnfluence of pregnancy on
the febrile response to intracerebroventricular
administration of PGEl in rats. J Appl Physiol l996; 81:
1312-1315.
27. Jaameri K, Jahkola A, Perttu J. On shivering in
association with normal delivery. Acta Obstet Gynecol
Scand. 1966;45: 383-388.

Thank you for copying data from http://www.arastirmax.com