Revista Colombiana de Obstetricia y Ginecología (Mar 2002)
Manejo activo del alumbramiento con Misoprostol sublingual: un estudio clínico controlado en el Hospital de Maternidad Rafael Calvo de Cartagena Active management of the childbirth with sublingual Misoprostol: a clinical controlled trial at Hospital de Maternidad Rafael Calvo
Abstract
OBJETIVOS: El objetivo del presente estudio es establecer la seguridad, eficacia y costos del Misoprostol sublingual, en el manejo activo del tercer periodo del parto. MATERIAL Y MÉTODOS: Se hace un estudio prospectivo, randomizado, controlado, donde se distribuyen 75 pacientes en tres grupos de 25 pacientes: A. Misoprostol sublingual, B. Oxitocina endovenosa, C. Metil-ergonovina postalumbramiento. Se cuantificó el sangrado durante la primera hora posparto y tiempo de alumbramiento. Se valoró el costo de los insumos utilizados en cada grupo, el comportamiento de los signos vitales antes y después del alumbramiento y los efectos colaterales de la droga en cada uno de los grupos. RESULTADOS: El sangrado en la primera hora posparto fue de 389cc ± 271.7 en el grupo de Misoprostol Vs 467cc ± 427.5 en el grupo de Oxitocina; Vs 546.8 ± 338.5 para el grupo de Metil-ergonovina postalumbramiento. Siendo estos resultados estadísticamente significativos pOBJECTIVES: The objective of the present study is to determine the security, efficacy and costs of the sublingual Misoprostol, in the active management of the third period of labor. MATERIALS AND METHODS: In a prospective study, randomized, controlled, where they are distributed 75 patient in three groups of 25 patient: A. Sublingual Misoprostol, B. Oxitocina IV, C. Metil-ergonovina after delivery of the placenta. Blood loss was estimated during the first hour after the vaginal delivery and difference in the third period of labor were measured. The cost of the drugs and materials used in each group was valued, the behavior of the vital signs before and after the childbirth and the collateral effects of the drug in each one of the groups. RESULTS: Blood loss during the first hour of vaginal delivery was from 389cc ± 271.7 in the group of Misoprostol Vs 467cc ± 427.5 in the group of Oxitocina; Vs 546.8 ± 338.5 for the group of Metil-ergonovina after delivery of the placenta. Being these outputs statistically significant p< 0.01. The time of childbirth was minor in the group of Misoprostol 308seg ± 57 Vs 362seg ± 162.3 with Oxitocina, Vs 557 ± [seg] 256.2 (p< 0.05). The costs with Misoprostol were $500 Vs $8,000 with Oxitocina and $2,000 with Metil-ergonovina. There were not collateral effects in any of the groups. CONCLUSION: The Use of 50mcgr of sublingual Misoprostol is sure, effective and economical in the third period of the labor.
