关键词:

凶险性前置胎盘, 卡前列素氨丁三醇, 止血效果, 妊娠结局, 用药安全性

Abstract:

Objective　To observe the therapeutic effect of carboprost trometamol on dangerous placenta previa and its effect on pregnancy outcomes. Methods　It was a randomized controlled trial. A total of 65 patients with dangerous placenta previa admitted to Tongxu County Hospital of Traditional Chinese Medicine from January 2019 to May 2022 were taken as the research objects. They were divided into a treatment group (33 cases) and a control group (32 cases) by the random number table method. The age of the treatment group was (29.12±0.41) years old, and the gestational age was (36.15±0.27) weeks. The age of the control group was (29.15±0.33) years old, and the gestational age was (36.11±0.32) weeks. Both groups were treated with cesarean section + conventional oxytocin injection + uterine gauze packing, the control group was treated with mifepristone on the basis, and the treatment group was treated with carboprost trometamol on the basis of the above treatment. The hemostasis, uterine arterial hemodynamics, pregnancy outcomes, and adverse drug reactions of the two groups were compared under different treatment schemes. χ² test and independent sample t test were used. Results　After different treatments, the bleeding volumes 3, 6, 9, and 12 hours after operation in the treatment group were lower than those in the control group (all P<0.05). The hemostatic time in the treatment group was shorter than that in the control group [(2.25±0.31) d vs. (4.15±0.27) d] (t=26.317, P<0.001), and the success rate of hemostasis was higher than that in the control group [84.85% (28/33) vs. 68.75% (22/32)] (χ²=7.274, P=0.007). There were no statistically significant differences in the uterine arterial hemodynamic indexes between the two groups before treatment (all P>0.05). After treatment, the pulsation index (PI) of the treatment group was higher than that of the control group [(0.84±0.11) vs. (0.72±0.14)] (t=3.849, P<0.001), the peak systolic flow velocity/diastolic flow velocity (S/D) of the uterine artery was higher than that of the control group [(2.35±0.85) vs. (2.02±0.13)] (t=2.171, P=0.034), and the resistance index (RI) was lower than that of the control group [(0.53±0.12) vs. (0.69±0.41)] (t=2.149, P=0.036). The incidence of adverse pregnancy outcomes in the treatment group was lower than that in the control group [15.15% (5/33) vs. 28.13% (9/32)] (χ²=4.968, P=0.026). The incidence of adverse drug reactions in the treatment group was higher than that in the control group [18.18% (6/33) vs. 15.63% (5/32)], but the difference was not statistically significant (χ²=0.232, P=0.630). Conclusions　In addition to routine hemostatic measures and mifepristone treatment for patients with dangerous placenta previa, the combined application of carboprost trometamol can enhance its hemostatic effect, which has positive significance in improving the uterine arterial hemodynamics and the patients' pregnancy outcomes. Moreover, the combined application of this drug does not significantly increase the risk of adverse drug reactions in patients, with high safety.

Key words:

Dangerous placenta previa, Carboprost trometamol, Hemostatic effect, Pregnancy outcomes, Medication safety