Sezaryen sırasında metilergometrin ve oksitosinin birlikte kullanımının doğum sonrası kanamayı önlemedeki etkisi

Abstract

Özet Amaç Doğum sonrası kanama (DSK), dünya çapında maternal morbidite ve mortaliteye katkıda bulunan önemli bir faktördür ve tedavi yöntemi veya bir tedavi yaklaşımının diğerine üstünlüğü konusunda bir fikir birliği yoktur. Bu çalışma, sezaryen doğumlarında doğum sonrası kanamayı önlemede oksitosin ve metilergonovin kombinasyonunun etkinliğini değerlendirmeyi amaçlamaktadır. Metodoloji Bu çalışma, Ocak-Aralık 2022 tarihleri arasında xxxxx Araştırma ve Eğitim Hastanesi'nde 18-35 yaş arası 1292 kadın hasta üzerinde retrospektif olarak yürütülmüştür. Katılımcılar iki gruba ayrılmıştır: biri sadece oksitosin alan grup, diğeri ise oksitosin ve metilergonovin kombinasyonu alan grup. Birincil sonuçlar, hemoglobin ve hematokrit düzeylerindeki değişikliklerle değerlendirilen doğum sonrası kanamayı (DSK) ve intraoperatif kan kaybını içermektedir. İkincil sonuçlar arasında ek intraoperatif hemostatik uterin sütürlerin kullanımı, cerrahi sürecin uzunluğu, ek uterotoniklere ihtiyaç duyulması ve kan transfüzyonu ihtiyacı yer aldı. Bulgular: Ek uterotonik ihtiyacında (%27,2 (182), %13,9 (87), p= 0,005), ameliyat öncesi ve sonrası hemoglobin konsantrasyonundaki değişimde 10,81±0,93, 8,23±1,11, p= 0,001 ve hematokrit (11,89±0,93, 10,31±1,20, p= 0,001) değişiminde anlamlı farklılıklar vardı. Ameliyat süresi, kan transfüzyonu gereksinimleri veya ek hemostatik sütür ihtiyacı açısından gruplar arasında anlamlı bir fark yoktu. Sonuçlar: Oksitosin ve metilergonovin kombinasyonu, sezaryen geçiren kadınlarda doğum sonrası kanamayı etkili bir şekilde azalttı. Bu grup daha az uterotonik tedaviye ihtiyaç duydu, hemoglobin ve hematokrit seviyelerinde daha küçük düşüşler yaşadı ve sezaryen sırasında daha az kan kaybı yaşadı

Keywords

• oksitosin
• metilergometrin
• postpartum kanama
• sezaryen

Supporting Institution

none

Ethical Statement

Etik Uygunluk: İnsan katılımcıları içeren tüm prosedürlerde, ilgili araştırma komitesi tarafından belirlenen etik standartlara titizlikle uyulmuş ve 1964 Helsinki Bildirgesi ve değişikliklerine tam olarak uyulmuştur. Etik onay: Çalışma, Helsinki Bildirgesi'nin 2013 tarihli değişikliği uyarınca xxxxxxx Eğitim ve Araştırma Hastanesi etik kurulundan onay almıştır (Onay numarası: 2023.06.84).

Thanks

YOK

The Effect of the Combined Use of methylergometrine and oxytocin during cesarean section in the prevention of post-partum haemorrhage

Abstract

Abstract Objective Postpartum hemorrhage (PPH) is an important contributory factor to maternal morbidity and mortality worldwide, and there is no consensus on treatment method or the superiority of one therapeutic approach over another. This study aimed to assess the efficacy of oxytocin compared with the combined administration of oxytocin and methylergometrine in preventing postpartum hemorrhage in cesarean sections. Methodology This study was conducted retrospectively on 1292 female patients aged 18-35 at the xxxxx Research and Training Hospital from January to December 2022. Participants were categorized into two groups: one receiving oxytocin alone and the other receiving a combination of oxytocin and methylergometrine The primary outcome measures included postpartum hemorrhage (PPH), assessed by changes in hemoglobin and hematocrit levels, in along with intraoperative blood loss. Secondary outcomes included the use of supplemental intraoperative hemostatic uterine sutures, the length of the surgical process, the need for further uterotonics, and the demand for blood transfusion. Results There were significant differences in the need for additional uterotonics 27.2(182) %,13.9% (87) p= 0.005, the change in pre-and postoperative hemoglobin concentration 10.81±0.93, 8.23±1.11, p= 0.001 and hematocrit 11.89±0.93, 10.31±1.20, p= 0.001 There were no significant differences between the groups in terms of operating time, blood transfusion requirements, or need for additional hemostatic sutures. Conclusions: The combination of oxytocin and methylergometrine effectively reduced postpartum bleeding in women undergoing cesarean sections. This group required less uterotonic treatment, had smaller declines in hemoglobin and hematocrit levels, and experienced less blood loss during cesarean section..

Keywords

• oxytocin
• methylergonovine
• postpartum hemorrhage
• cesarean section

Supporting Institution

The authors stated that this study received no financial support.

Ethical Statement

Ethical Compliance: All procedures involving human participants rigorously adhered to the ethical standards established by the relevant research committee and fully complied with the 1964 Helsinki Declaration and its amendments. Ethical approval: The study received approval from the ethics committee of xxxxxxx Training and Research Hospital in accordance with the 2013 modification of the Declaration of Helsinki (Approval number: 2023.06.84).

Thanks

NONE

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