Article type
Year
Abstract
Background: Both in developed or developing countries, postpartum hemorrhage are the most important reason for maternal mortality. Oxytocin is limited to the temporary duration of contraction only in upper uterus with receptor saturation effects. Motherwort Injection composites alkaloids such as Leonurine and Stachydrine, may be the potential ideal drug with oxytocin for postpartum hemorrhage prevention in Caesarean section.
Objectives: To assess the effectiveness and safety of motherwort injections in prevention of postpartum hemorrhaging in Caesarean section.
Methods: RCTs were searched in electronic database till January 2012. After quality evaluation by Cochrane systematic review manual 5.1, RevMan 5.1 was used to perform meta-analyses. Clinical recommendations were formed based on GRADE guidelines.
Results: A total of 37 RCTs involving 6954 patients is included. (1) M(motherwort injections) vs. O (oxytocin): there are not statistically significant differences between two groups in hemorrhage rate [RR = 0.86, 95%CI (0.40, 1.86), P = 0.71], and postpartum hemorrhage in 24 hours [[MD= −27.42, 95%CI (−66.71, 11.88), P=0.17]], respectively. (2)M+O+M course [M plusO by uterine wall injection+ maintenance dose of M]vs.. O+O course [O by uterine wall injection+ maintenance dose ofO]: there are statistically significant differences in hemorrhage rate [RR = 0.49, 95%CI(0.36, 0.66), P < 0.0001], postpartum hemorrhage in 2 hours [MD= −84.48, 95%CI(−154.53, −14.44), P = 0.02] and 24 hours [MD = −46.44, 95%CI(−53.45, −39.43), P < 0.0001].(3) M+Ovs. O: there are statistically significant differences in hemorrhage rate [RR = 0.18, 95%CI(0.06, 0.51), P = 0.001], postpartum hemorrhage in 2 hours [MD= −98.33, 95%CI(−189.14, −7.52), P = 0.03] and in 24 hours [MD= −72.62, 95%CI(−76.75, −68.48), P < 0.0001], respectively.
Conclusions: Motherwort injections cause slow but continuing contraction of whole uterus that would complement and cooperate with oxytocin in postpartum hemorrhaging prevention. Currently, research evidence supports clinical recommendation of combined use of motherwort injections with oxytocin than oxytocin in Caesarean section postpartum hemorrhage prevention with moderate intensity of recommendation.
Objectives: To assess the effectiveness and safety of motherwort injections in prevention of postpartum hemorrhaging in Caesarean section.
Methods: RCTs were searched in electronic database till January 2012. After quality evaluation by Cochrane systematic review manual 5.1, RevMan 5.1 was used to perform meta-analyses. Clinical recommendations were formed based on GRADE guidelines.
Results: A total of 37 RCTs involving 6954 patients is included. (1) M(motherwort injections) vs. O (oxytocin): there are not statistically significant differences between two groups in hemorrhage rate [RR = 0.86, 95%CI (0.40, 1.86), P = 0.71], and postpartum hemorrhage in 24 hours [[MD= −27.42, 95%CI (−66.71, 11.88), P=0.17]], respectively. (2)M+O+M course [M plusO by uterine wall injection+ maintenance dose of M]vs.. O+O course [O by uterine wall injection+ maintenance dose ofO]: there are statistically significant differences in hemorrhage rate [RR = 0.49, 95%CI(0.36, 0.66), P < 0.0001], postpartum hemorrhage in 2 hours [MD= −84.48, 95%CI(−154.53, −14.44), P = 0.02] and 24 hours [MD = −46.44, 95%CI(−53.45, −39.43), P < 0.0001].(3) M+Ovs. O: there are statistically significant differences in hemorrhage rate [RR = 0.18, 95%CI(0.06, 0.51), P = 0.001], postpartum hemorrhage in 2 hours [MD= −98.33, 95%CI(−189.14, −7.52), P = 0.03] and in 24 hours [MD= −72.62, 95%CI(−76.75, −68.48), P < 0.0001], respectively.
Conclusions: Motherwort injections cause slow but continuing contraction of whole uterus that would complement and cooperate with oxytocin in postpartum hemorrhaging prevention. Currently, research evidence supports clinical recommendation of combined use of motherwort injections with oxytocin than oxytocin in Caesarean section postpartum hemorrhage prevention with moderate intensity of recommendation.