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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 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.