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<b>Aim: </b> To compare maternal and neonatal outcomes of Tibetan and Han Chinese women delivering vaginally at high altitude (3650 meters) in Lhasa, Tibet Autonomous Region, People's Republic of China.<br><b>Method: </b> Comparative analysis of data from a prospective observational study of Tibetan (<i>n</i> = 938) and Han Chinese (<i>n</i> = 146) women delivering at three hospitals between January 2004 and May 2005.<br><b>Results: </b> Han Chinese women had higher rates of pre-eclampsia/gestational hypertension than Tibetan women, (10.3% vs 5.9%, <i>P</i> = 0.04). There was no difference in rates of postpartum hemorrhage between Tibetan and Han women (12.8% vs 17.1%, <i>P</i> = 0.15). Han newborns weighed significantly less than Tibetan newborns (<i>P</i> < 0.01), and were twice as likely to be small for gestational age, (24.5% vs 11.6%, <i>P</i> < 0.01). Tibetan newborns were less likely to have poor neonatal outcomes than Han newborns (<i>P</i> < 0.01).<br><b>Conclusion: </b> In high altitude deliveries in Tibet, adverse outcomes were significantly more common among Han Chinese.
The article focuses on the study which aims to develop an informed consent process of Tibetan traditional medicine through a randomized placebo-controlled trial in Lhasa, China. The study reveals a process that enables the U.S. and Tibetan research team in meeting their ethical and logistical challenges, and examines the differences between the outcomes. Moreover, a step-by-step process on how participants would react to the research and informed consent process were presented.
The objective of this study was to compare a Tibetan traditional medicine (the uterotonic Zhi Byed 11 [ZB11]) to oral misoprostol for prophylaxis of postpartum hemorrhage (PPH). We conducted a double-blind randomized controlled trial at three hospitals in Lhasa, Tibet, People''s Republic of China. Women (N = 967) were randomized to either ZB11 or misoprostol groups. Postpartum blood loss was measured in a calibrated blood collection drape. The primary combined outcome was incidence of PPH, defined as measured blood loss (MBL) ≥ 500 mL, administration of open label uterotonics, or maternal death. We found that the rate of the combined outcome was lower among the misoprostol group (16.1% versus 21.8% for ZB11; P = .02). Frequency of PPH was lower with misoprostol (12.4% versus 17.4%; P = .02). There were no significant differences in MBL > 1000 mL or mean or median MBL. Fever was significantly more common in the misoprostol group (P = .03). The rate of combined outcome was significantly lower among women receiving misoprostol. However, other indices of obstetric hemorrhage were not significantly different.