为什么莫斯塔法-马吉德手法更好?莫斯塔法-马吉德手法与双人子宫挤压法治疗产后出血的比较

Medicine Advances Pub Date : 2024-05-29 DOI:10.1002/med4.61
Mostafa Maged Ali, Mustafa Rabie Mohamed Elsharkawy
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引用次数: 0

摘要

背景 本研究旨在探讨在处理阴道分娩产后出血时,Mostafa Maged 手法与双人子宫压迫法的有效性比较。 方法 这是一项涉及 200 名患者的前瞻性研究,分为两组,每组 100 名患者。第一组接受(Mostafa Maged 手法),第二组接受(常规双人子宫挤压)。Mostafa Maged 手法要求将右手放在后穹窿,左手经腹部外侧放在子宫底和子宫后壁。随后的步骤是将整个子宫顶在耻骨联合上。我们确定了每次操作的持续时间,直到操作者疲劳为止,并评估了每次操作按压后是否注射催产素。 结果 第一组(莫斯塔法-马吉德手法)中没有患者需要输血,而第二组则不同,每 100 名患者中就有 17 人在双手法按压后输血。在使用催产素方面,组间差异有统计学意义(p < 0.001)。采用 Mostafa Maged 手法的平均持续时间为 12.7 分钟(范围:11-15 分钟)。双手法子宫挤压(第二组)的平均持续时间为 4.04 分钟(范围:3.5-4.5 分钟)。与双人子宫按压法相比,莫斯塔法-马吉德手法的持续时间和出现疲劳的时间明显更短(分别为 p = 0.02 和 p = 0.001)。相比之下,两组在处理患者和输血率方面的差异无统计学意义。 结论 莫斯塔法-马吉德手法与双人子宫挤压法相比,简单易学,操作可行。莫斯塔法-马吉德手法可能是目前治疗失张力性产后出血的保守疗法的重要补充,尤其是对于那些缺乏培训和专业知识,无法实施更复杂手术的产科医生,以及那些在设备简陋的设施中工作的产科医生而言。 试验注册 临床试验注册,包括注册日期:NCT06002256。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Why the Mostafa Maged maneuver is better: Mostafa Maged maneuver compared with bimanual uterine compression for postpartum hemorrhage

Why the Mostafa Maged maneuver is better: Mostafa Maged maneuver compared with bimanual uterine compression for postpartum hemorrhage

Background

This study aimed to investigate the effectiveness of the Mostafa Maged maneuver compared with bimanual uterine compression for the management of postpartum hemorrhage during vaginal delivery.

Methods

This was a prospective study involving 200 patients divided into two groups with 100 patients in each group. Group I received (Mostafa Maged maneuver), and Group II received (routine bimanual uterine compression). The Mostafa Maged maneuver requires placing the right hand in the posterior fornix and positioning the left hand on the uterine fundus and posterior uterine wall via the abdomen exteriorly. The subsequent step involves holding the entire uterus against the symphysis pubis. We determined the duration of each maneuver until practitioner fatigue and evaluated whether oxytocin was administered after compression for each maneuver.

Results

No patients required blood transfusions in Group I (Mostafa Maged maneuver), unlike in Group II, in which 17/100 patients received blood transfusions after bimanual compression. There was a statistically significant difference (p < 0.001) between the groups regarding the administration of oxytocin. The mean duration of applying the Mostafa Maged maneuver was 12.7 min (range: 11–15 min). The mean duration of bimanual uterine compression (Group II) was 4.04 min (range: 3.5–4.5 min). There was a statistically significantly shorter duration for the Mostafa Maged maneuver and shorter time to onset of fatigue compared with bimanual uterine compression (p = 0.02, and p = 0.001, respectively). In contrast, there were no statistically significant differences between both groups for the dealing with the patient and the blood transfusion rate.

Conclusion

The Mostafa Maged maneuver is easy to learn and feasible to perform compared with bimanual uterine compression. The Mostafa Maged maneuver may be a valuable addition to current conservative treatments for atonic postpartum hemorrhage, especially for obstetricians who lack the training and expertise to perform more complex procedures and those working in minimally equipped facilities.

Trial registration

Clinical trial registration, including the date of registration: NCT06002256.

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