Article type
Year
Abstract
Background: In developing countries, due to the lack of equipment and well-trained medical staff, more economical and feasible intervention of reducing maternal mortality is preventing of postpartum hemorrhage than treating. Oxytocin is limited to the temporary duration of contraction only in upper uterus with receptor saturation effects. Motherwort Injection is the potential ideal drug with oxytocin for postpartum hemorrhage prevention in vaginal delivery.
Objectives: To assess the effectiveness and safey of motherwort injections in prevention of postpartum hemorrhaging in vaginal delivery.
Methods: Related RCTS were searched in English and Chinese database. After quality evaluation by Cochrane systematic review manual, meta-analyses were performed by RevMan 5.1.
Results: A total of 20 RCTs involving 4065 patients is included. (1) M(motherwort injections) vs. O (oxytocin): there are statistically significant differences in hemorrhage rate [RR = 0.57, 95%CI(0.33, 0.98), P = 0.04], postpartum hemorrhage in 24 hours [MD= −64.87, 95%CI(−84.92, −44.81), P < 0.00001] and risk of adverse reaction [RR = 0.10, 95%CI(0.01, 0.87), P = 0.04], respectively. (2) M+O+M course [M plus O by uterine wall injection + maintenance dose of M] vs. O+O course [O by uterine wall injection + maintenance dose of O]: there are statistically significant differences in postpartum hemorrhage in 2 hours [MD = −29.79, 95%CI(−53.82, −5.76), P = 0.02] and 24 hours [MD = −56.38, 95%CI(−107.43, −5.34), P = 0.03], respectively. (3) M+O (motherwort injections plus oxytocin) vs. O(oxytocin): there are statistically significant differences in hemorrhage rate [RR = 0.32, 95%CI(0.19, 0.54), P < 0.0001], postpartum hemorrhage in 2 hours [MD = −51.46, 95%CI(−64.76, −38.16), P <0.0001] and postpartum hemorrhage in 24 hours [MD= −80.06, 95%CI(−88.08, −72.03), P < 0.0001], respectively.
Conclusions: Motherwort injections combined with oxytocin, compare with oxytocin, can effectively decrease hemorrhage rate, postpartum hemorrhaging in 2 and 24 hours and didn’t increase risk of adverse reaction. Currently, research evidence supports clinical recommendation of combined use of motherwort injections with oxytocin than oxytocin in vaginal delivery postpartum hemorrhage prevention with moderate intensity of recommendation and moderate intensity of selected bias.
Objectives: To assess the effectiveness and safey of motherwort injections in prevention of postpartum hemorrhaging in vaginal delivery.
Methods: Related RCTS were searched in English and Chinese database. After quality evaluation by Cochrane systematic review manual, meta-analyses were performed by RevMan 5.1.
Results: A total of 20 RCTs involving 4065 patients is included. (1) M(motherwort injections) vs. O (oxytocin): there are statistically significant differences in hemorrhage rate [RR = 0.57, 95%CI(0.33, 0.98), P = 0.04], postpartum hemorrhage in 24 hours [MD= −64.87, 95%CI(−84.92, −44.81), P < 0.00001] and risk of adverse reaction [RR = 0.10, 95%CI(0.01, 0.87), P = 0.04], respectively. (2) M+O+M course [M plus O by uterine wall injection + maintenance dose of M] vs. O+O course [O by uterine wall injection + maintenance dose of O]: there are statistically significant differences in postpartum hemorrhage in 2 hours [MD = −29.79, 95%CI(−53.82, −5.76), P = 0.02] and 24 hours [MD = −56.38, 95%CI(−107.43, −5.34), P = 0.03], respectively. (3) M+O (motherwort injections plus oxytocin) vs. O(oxytocin): there are statistically significant differences in hemorrhage rate [RR = 0.32, 95%CI(0.19, 0.54), P < 0.0001], postpartum hemorrhage in 2 hours [MD = −51.46, 95%CI(−64.76, −38.16), P <0.0001] and postpartum hemorrhage in 24 hours [MD= −80.06, 95%CI(−88.08, −72.03), P < 0.0001], respectively.
Conclusions: Motherwort injections combined with oxytocin, compare with oxytocin, can effectively decrease hemorrhage rate, postpartum hemorrhaging in 2 and 24 hours and didn’t increase risk of adverse reaction. Currently, research evidence supports clinical recommendation of combined use of motherwort injections with oxytocin than oxytocin in vaginal delivery postpartum hemorrhage prevention with moderate intensity of recommendation and moderate intensity of selected bias.