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Motherwort injection for preventing postpartum hemorrhage in pregnant women with cesarean section: A systematic review and meta‐analysis
Author(s) -
Chen Wenwen,
Yu Jiajie,
Tao Huan,
Cai Yujia,
Li Youping,
Sun Xin
Publication year - 2018
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12300
Subject(s) - medicine , meta analysis , caesarean section , randomized controlled trial , oxytocin , adverse effect , cochrane library , obstetrics , relative risk , pregnancy , confidence interval , genetics , biology
Objective To assess the impact of motherwort injection alone or combined with oxytocin for preventing postpartum hemorrhage in pregnant women with caesarean section. Methods A systematic review and meta‐analysis of randomized trials were performed. PubMed, EMbase, The Cochrane Central Register of Controlled Trials (CENTRAL), Chinese database Sino‐Med, Chinese National Knowledge Infrastructure Database (CNKI), VIP Chinese Science and Technique Journals Database, WanFang, and ClinicalTrials.gov were searched. Randomized controlled trials (RCTs) that compared motherwort injection alone or motherwort injection combined with oxytocin in pregnant women receiving cesarean section were included. Paired reviewers independently screened abstracts and full texts for eligibility, assessed risk of bias, and extracted data. We performed random‐effects meta‐analyses of RCTs along with a limited number of prespecified subgroup hypotheses, and sensitivity analyses were carried out with other statistical approaches. Results Forty‐six RCTs ( n = 7359) proved eligible. Compared with oxytocin, both motherwort injection and motherwort injection combined with oxytocin had a significantly lower blood loss within 2 hours (MD = −21.81, 95% CI −37.05 to −6.58 and MD = −53.04, 95% CI −61.68 to −44.39); lower blood loss within 24 hours (MD = −25.44, 95% CI −39.38 to −11.51 and MD = −67.81, 95% CI −78.02 to −57.60); and lower the risk of adverse events (OR Peto 0.40, 95% CI 0.16 to 0.96 and OR Peto 0.50, 95% CI 0.35 to 0.71). Motherwort injection combined with oxytocin also decreased the risk of postpartum hemorrhage (OR 0.22, 95% CI 0.14 to 0.35.) Conclusions In pregnant women with cesarean section, motherwort injection suggests an obvious benefit and less adverse event.