Meta-analysis of Misoprotol Combined with 10% Calcium Gluconate Injection in the Treatment of Postpar-tum Hemorrhage / 中国药房

ABSTRACT

OBJECTIVE:To systematically review the efficacy and safety of misoprostol combined with 10% Calcium gluco-nate injection in the treatment of postpartum hemorrhage,and provide evidence-based reference for the clinical treatment. METH-ODSRetrieved from PubMed,EMBase,Ovid,CBM,CJFD and VIP,randomized controlled trials (RCT) about misoprostol combined with 10% Calcium gluconate injection (test group) versus conventional oxytocin in the treatment of postpartum hemor-rhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Co-chrane systematic review manual 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 1254 pregnant women. Results of Me-ta-analysis showed,compared with conventional oxytocin,misoprostol combined with 10% Calcium gluconate injection can signifi-cantly reduce 2 h postpartum hemorrhage [MD=-76.76,95%CI(-105.73,-47.79),P<0.001],24 h postpartum hemorrhage [MD=-118.28,95%CI(-167.78,-68.78),P<0.001] and the incidence of postpartum hemorrhage [OR=0.19,95%CI(0.08, 0.46),P<0.001],and shorten the 3rd delivery process [MD=-3.52,95%CI(-4.20,-2.84),P<0.001],the differences were sta-tistically significant;there was no significant difference in the intraoperative hemorrhage [MD=-61.31,95%CI(-121.98,-0.64), P=0.05] and neonatal 1 min Apgar score [MD=0.10,95%CI(-0.38,0.59),P=0.67] in 2 groups. The incidences of chest dis-tress,breathlessness and stomach discomfort in test group were significantly higher than control group [OR=18,95%CI(2.42, 133.98),P=0.005],but it was mild,and there was no significant difference in the incidence of fver,chills and nausea,vomiting, diarrhea and other adverse reactions. CONCLUSIONS:Both the efficacy and safety of misoprostol combined with 10% Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies, more large-scale and long-term follow-up studies with strict designed are required for further validation of the conclusions.