Open AccessProstaglandins for Postpartum Hemorrhage: Pharmacology, Application, and Current Opinion
Author(s) -
Yue Chen,
Wei Jiang,
Yunchun Zhao,
Dawei Sun,
Xiao Zhang,
Wu Fan,
Caihong Zheng
Publication year - 2021
Publication title -
pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.51
H-Index - 59
eISSN - 1423-0313
pISSN - 0031-7012
DOI - 10.1159/000516631
Subject(s) - uterotonic , misoprostol , uterine atony , medicine , intensive care medicine , oxytocin , prostaglandin analogue , pregnancy , prostaglandin , hysterectomy , abortion , surgery , biology , genetics
Background: Postpartum hemorrhage (PPH) remains a common cause of maternal mortality worldwide. Medical intervention plays an important role in the prevention and treatment of PPH. Prostaglandins (PGs) are currently recommended as second-line uterotonics, which are applied in cases of persistent bleeding despite oxytocin treatment. Summary: PG agents that are constantly used in clinical practice include carboprost, sulprostone, and misoprostol, representing the analogs of PGF 2α , PGE 2 , and PGE 1 , respectively. Injectable PGs, when used to treat PPH, are effective in reducing blood loss but probably induce cardiovascular or respiratory side effects. Misoprostol is characterized by oral administration, low cost, stability in storage, broad availability, and minimal side effects. It remains a treatment option for uterine atony in low-resource settings, but its effectiveness as a uterotonic for independent application may be limited. Key Messages: The present review article discusses the physiological roles of various natural PGs, evaluates the existing evidence of PG analogs in the prevention and treatment of PPH, and finally provides a reference to assist obstetricians in selecting appropriate uterotonics.