Carboprost suppositories for prevention and treatment of postpartum hemorrhage: a systematic review

Objective To systematically assess the effect of Carboprost Suppositories in prevention and treatment of postpartum hemorrhage, postpartum exhaust and urine retention. Methods Randomized controlled trials and clinical controlled trials of Carboprost Suppositories in prevention and treatment of obstetrical diseases were searched in Chinese Biomedical Literature Database, China National Knowledge Infrastructure, et al. The quality of the included studies was evaluated and the data were extracted by two assessors independently. Meta-analyses were performed with Stata software. Results 23 studies on preventing postpartum hemorrhage, 8 studies on treatment of postpartum hemorrhage,3 studies on treatment of postpartum exhaust and 3 studies on treatment of urine retention were identified. The Meta-analyses on preventing postpartum hemorrhage showed that Carboprost Suppositories statistically decrease the amount of 2-hour hemorrhage, 24-hour hemorrhage and shorten the time of third stage of labor and the corresponding mean difference and 95%CI were -69.25(-81.31,-57.20)、-93.01(-106.82,-79.19) and -3.52(-4.12,-2.92)(P0.05). The Meta-analyses on treating postpartum hemorrhage indicated that Carboprost Suppositories could decrease the amount of 2-hour hemorrhage (71.46 mL) and 24-hour hemorrhage (73.37 mL), and shorten the time of third stage of labor (2.94 min). Carboprost Suppositories could shorten the time of postpartum exhaust about 16.48 hours. All of these results were statistically significant. However there is no statistically significance in the treatment of urine retention (RR 1.67,95%CI 0.62~1.56). Conclusion The present meta-analysis convinced that Carboprost Suppositories plays significant role in prevention and treatment of postpartum hemorrhage and shorten the time of postpartum exhaust. Yet, more and higher level randomized controlled trials are also needed to further confirm the conclusion.