Preventive effect of carboprost tromethamine and ergometrine on postpartum hemorrhage and their influence on uterine involution in puerperae undergoing cesarean section

Yu Ya-ting; Li Si-mei; Zhang Jing-wen

doi:10.3969/j.issn.1672-8157.2024.03.010

Abstract：Objective To observe the preventive effect of carboprost tromethamine and ergometrine on postpartum hemorrhage and their influence on uterine involution in puerperae undergoing cesarean section.Methods The clinical data of 118 patients undergoing cesarean section in Hefei First People's Hospital from March 2019 to January 2024 were retrospectively analyzed.According to different postpartum intervention methods,they were divided into group A(n=48,ergometrine),group B(n=33,carboprost tromethamine)and group C(n=37,carboprost tromethamine+ergometrine).The postpartum blood loss,lochia duration,hospitalization time,incidence of postpartum hemorrhage and uterine involution were compared among the three groups.The adverse medication reactions in the three groups were also evaluated.Results There was no significant difference in blood loss at 2 h and 24 h after delivery,lochia duration or hospitalization time between group A and group B[(343.58±49.32)mL,(426.35±68.65)mL,(18.25±3.21)d,(5.26±0.25)d vs(341.63±54.27)mL,(431.25±63.59)mL,(17.98±2.66)d,(5.34±0.32)d],the difference was not statistically significant(t=0.168,0.325,0.398,1.261,P=0.867,0.746,0.692,0.211).The blood loss at 2 h and 24 h after delivery,lochia duration and hospitalization time in group C were(215.65±42.36)mL,(301.36±50.35)mL,(14.21±2.14)d and(4.21±0.43)d,respectively.They were lower than those in group A and B(C vs A:t=16.968,13.030,9.465,20.289,P<0.001;C vs B:t=15.267,12.372,8.070,19.950,P<0.001).The incidence of postpartum hemorrhage in the three groups was 4.17%,30.3%and 0,the difference was not statistically significant among the three groups(P=0.624).On day 3 and 5 after delivery,there was no significant difference in uterine decline degree between group A and group B[(2.09±0.18)cm,(4.03±0.25)cm vs(2.16±0.39)cm,(4.15±0.34)cm],the difference was not statistically significant(t=1.088,1.831,P=0.280,0.071).However,it was(2.94±0.23)cm and(4.89±0.29)cm in group C,significantly higher than that in group A and B(C vs A:t=20.460,17.154,P<0.001;C vs B:t=19.177,15.077,P<0.001).The total incidence of adverse reactions in the group A,B and C was 14.58%,9.09%and 24.32%,and the difference was not statistically significant among the three groups(χ2=3.134,P=0.209).Conclusion Both carboprost tromethamine and ergometrine can effectively promote uterine contraction,prevent postpartum hemorrhage and promote uterine involution.The combined application of these two drugs may have synergistic effect,which can further improve clinical effect.