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OBJECTIVE:To evaluate therapeutic efficacy and safety of romethamine for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section,and to provide evidence-based reference in clinic. METHODS:Retrieved from CNKI,Wanfang database,VIP,CBM and PubMed,randomized controlled trials(RCT)about romethamine(trial group)vs. routine therapy alone,or routine therapy combined(with)misoprostol(control group)for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. RESULTS:A total of 18 RCTs were included finally,involving 1 824 patients. Results of Meta-analysis showed that intraoperative bleeding amount[MD=-138.16,95%CI(-162.97,-113.35),P<0.001],bleeding amount 2 h after surgery[MD=-134.33,95%CI(-149.87,-118.79),P<0.001],bleeding amount 24 h after surgery[MD=-150.78,95%CI(-171.20,-130.37),P<0.001] and the incidence of postoperative hemorrhage [OR=0.22,95%CI(0.10,0.47),P<0.001] in trial group were significantly lower than control group,with statistical significance. The incidence of ADR in trial group was significantly lower than control group [OR=2.37,95% CI(1.09,5.17),P=0.03],with statistical significance. CONCLUSIONS:Romethamine can reduce intraoperative and postoperative bleeding amount in placenta previa puerperal during caesarean section, and do not increase the occurrence of ADR.
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Objective To analyze the effect of carboprost methylate suppository combined with romethamine in the treatment of postpartum hemorrhage in contractions fatigue.Methods 120 cases of postpartum hemorrhage contractions fatigue were randomly divided into control group and observation group,60 cases in each group.The control group was given carboprost methylate suppository treatment,the observation group was given romethamine com-bined with carboprost methylate suppository.The 2h,12h postpartum blood loss,clinical treatment effect and adverse reaction were compared between the two groups.Results Compared with the control group,the hemostatic time of the observation group shortened,postpartum haemorrhage amount within 2h and postnatal within 12h blood loss of the observation group were reduced,the differences were statistically significant (t=4.56,5.92,6.12,all P<0.05).The total effective rate of the control group was 73.33%,which was significantly lower than 91.67% of the observation group,the difference was statistically significant (χ2 =6.12,P <0.05 ).Compared with the control group,the incidence rates of digestive tract symptoms,disposable blood pressure fluctuations,facial blushing,puerperal infection in the observation group were lower,the differences were statistically significant (χ2 =4.71,4.98,4.34,5.43,all P<0.05).Conclusion The clinical effect of carboprost methylate suppository combined with romethamine in the the treatment of contractions fatigue postpartum hemorrhage is remarkable,with less postpartum haemorrhage amount, better treatment effect,low incidence of adverse reactions and higher security.
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Objective To study curative efficacy of carboprost romethamine in treatment of postpartum hemorrhage of pregnancy and its effects on fibrinogen(FIB) and D-dimer(D-D).Methods106 patients of chronic renal failure who received therapy from November 2015 to November 2016 in our hospital were selected.According to random number table, those patients were divided into the observation group (n=53) and the control group (n=53).The control group was treated with oxytocin after delivery, while the observation group was treated with carboprost romethamine.The postoperative 2h and 24h bleeding volume, contraction duration, duration of lochia, uterus decreased speed and the changes of FIB and D-D before and after treatment were compared, and comparison of adverse reactions.ResultsThe postoperative 2h and 24h bleeding volume in the observation group were significantly lower than those in the control group[(231.58±36.79)mL vs (345.62±45.60)mL, (301.24±44.01)mL vs (445.23±61.74)mL] (P<0.05);compared with the control group, the observation group contraction duration longer, duration of lochia was shorter, uterus decreased was faster(P<0.05);before treatment, there was no significant difference in FIB and D-D between the two groups;after treatment, the levels of FIB and D-D in the control group did not change significantly;the levels of FIB and D-D in the observation group were significantly reduce, and the result were lower than those in the control group(P<0.05);there was no significant difference in the incidence of nausea and vomiting, chest pain, chills between the two groups.ConclusionCarboprost romethamine is well for postpartum hemorrhage of pregnancy, which can effectively improve blood hypercoagulable state, reduce the amount of postpartum hemorrhage, it's worthy of application and promotion.
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Objective To explore the curative effect and safety of romethamine combined with dexamethasone on the postpartum hemorrhage for patients with high risk pregnancy.Methods 80 patients with high risk pregnancy were enrolled in our hospital from June 2014 to June 2016,of which patients divided into two group randomly,Group A (n =40) accepted romethamine for hemostasis treatment,and Group B (n =40) adopted romethamine combined with dexamethasone treatment.The clinical effect and hemorrhage of patients with postpartum hemorrhage were compared,and the adverse reactions were recorded and analyzed in the period of treatment.Results After treatment,the difference of total effective rate for postpartum hemorrhage from two groups was no significance.After given medicines 0.5 h respectively in delivery process,the SBP,DBP and HR of all parturient women were rising compared with before medicine administration remarkably (P ＜ 0.05),but the difference of those between two groups was no significance.Within 24 h after delivery,the hemorrhage of Group B was lower significantly than those patients in Group A (P ＜ 0.05).The difference of shock index (SI) from Group A and Group B was no significance.The incidence of nausea and vomiting in Group B was lower than those Group A significantly (P ＜ 0.05),and the case of total adverse reactions in group B was fewer significantly than those Group A (P ＜ 0.05).Conclusions The romethamine combined with dexamethasone for the postpartum hemorrhage in patients with high risk pregnancy deserved popularization in clinic,of which not only possessed remarkably clinical effect and well safety,but also controlled the postpartum hemorrhage effectively and decreased the incidence of the adverse reactions in the period of treatment.
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Objective To explore the curative effect of the different utilized timing of romethamine in cesarean section with central placenta previa.Methods All of 148 patients with central placenta previa were divided into observation group (74 patients) and control group (74 patients) according to the serial number.The patients in observation group were given romethamine after breaking off umbilical core,the patients in control group were given romethamine after placental expulsion.The intraoperative blood loss,postoperative 24 h blood loss,operation time,rate of automatic placental expulsion and adverse reaction were compared.Results The intraoperative blood loss in observation group was less than that in control group[(503.5 ± 320.8) ml vs.(672.1 ± 409.6) ml],the rate of automatic placental expulsion was higher than that in control group [79.73％ (59/74) vs.54.05％ (40/74)],the operation time was less than that in control group [(42 ± 15) min vs.(55 ± 16) min],there was significant difference (P ＜0.05 or ＜0.01).The postoperative 24 h blood loss and the adverse reaction between two groups had no significant difference (P ＞ 0.05).Conclusions In cesarean section with central placenta previa,given romethamine after breaking off umbilical core can improve the rate of automatic placental expulsion,shorten operation time,decrease intraoperative blood loss.It is worthy of spreading.