Misoprostol oral u oxitocina intramuscular en la tercera fase del parto
[Oral misoprostol or intramuscular oxytocin in third stage of labor]Maira Sarmiento-Piña1, Eduardo Reyna-Villasmil1, Jorly Mejía-Montilla2, Nadia Reyna-Villasmil2, Duly Torres-Cepeda1, Martha Rondón-Tapia1, Carlos Briceño-Pérez2
1. Servicio de Ginecología y Obstetricia Hospital Central Dr. Urquinaona, Maracaibo, Venezuela; 2. Facultad de Medicina de la Universidad del Zulia. Maracaibo, Venezuela.
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Resumen
Objetivo: Comparar la efectividad del misoprostol oral vs. oxitocina intramuscular en el manejo de la tercera fase del parto. Metodología: Se realizó un estudio de casos y controles en pacientes embarazadas tratadas con misoprostol oral (grupo A) u oxitocina intramuscular (grupo B) para el manejo de la tercera fase del parto. Se analizaron las características generales, valores de hemoglobina y hematocrito, perdida hemática post-parto y efectos adversos. Resultados: Los datos se obtuvieron en 191 en el grupo A y 197 en el grupo B. No se encontraron diferencias significativas entre los grupos en las características generales. Tampoco se encontraron diferencias significativas en los valores promedio de hemoglobina - hematocrito post-parto, duración de la tercera fase del parto y perdidas sanguíneas entre los grupos, así como en el uso de uterotónicos adicionales y necesidad de hemoderivados. Las pacientes del grupo A presentaron mayor frecuencia de escalofríos, diarrea, náuseas y fiebre comparado con el grupo B (p < 0,05). Conclusión: El misoprostol oral es igual de efectivo que la oxitocina intramuscular cuando se usa como agente farmacológico para el manejo de la tercera fase del parto.
Abstract
Objective: To compare the effectiveness of oral misoprostol vs. intramuscular oxytocin in the management of the third stage of labor. Methodology: A case-control study was carried out in pregnant patients treated with oral misoprostol (group A) or intramuscular oxytocin (group B) for the management of the third stage of labor. General characteristics, hemoglobin and hematocrit values, postpartum blood loss and adverse effects were analyzed. Results: The data were obtained in 191 in group A and 197 in group B. No significant differences were found between groups in general characteristics. There were also no significant differences in mean postpartum hemoglobin-hematocrit values, duration of the third stage of labor and blood loss between the groups, as well as in the use of additional uterotonics and the need for blood products. Patients in group A had a higher frequency of chills, diarrhea, nausea and fever compared to group B (p < 0.05). Conclusion: Oral misoprostol is as effective as intramuscular oxytocin when used as a pharmacological agent for the management of the third stage of labor.
Citas
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