A double‐blind, randomized, placebo‐controlled trial of misoprostol and routine uterotonics for the prevention of postpartum hemorrhage

Fawole, Adeniran O.; Sotiloye, O S; Hunyinbo, Kehinde I.; Umezulike, AC; Okunlola, Michael A.; Adekanle, Daniel Adebode; Osamor, Jonathan; Adeyanju, Olusoji; Olowookere, O O; Adekunle, Adeyemi O.; Singata, Mandisa; Mangesi, Lindeka; Hofmeyr, G Justus

doi:10.1016/j.ijgo.2010.08.023

Cited by 23 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shivering and pyrexia were found to be significant adverse effects in the misoprostol group in the present study; again, similar observations have been made in almost all other studies in identical proportions [3][4][5][6][7][8][9][10][16][17][18][19][20][21][22].…”

Section: Discussionsupporting

confidence: 90%

“…Two recent studies found a diminution of blood loss on the addition of a 400-μg sublingual dose of misoprostol to routine oxytocic use; however, this difference was not significant [21,22].…”

Section: Discussionmentioning

confidence: 94%

“…Sublingual administration of misoprostol has been found to be beneficial in preventing PPH after cesarean delivery [14,15]. A few studies have evaluated efficacy of sublingual misoprostol for prophylaxis of PPH in vaginal deliveries [16][17][18][19][20][21][22]; however, none of them compared the efficacy of this treatment with that of 10 units of intramuscular oxytocin, which is the standard recommended by the WHO [2].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

Chaudhuri¹,

Biswas²,

Mandal³

2011

International Journal of Gynecology & Obstetrics

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

Chaudhuri¹,

Biswas²,

Mandal³

2011

International Journal of Gynecology & Obstetrics

View full text Add to dashboard Cite

show abstract

“…Our results contrast with findings from trials conducted in Africa evaluating the use of misoprostol as an add-on to routine uterotonics in the prevention of PPH. Both Fawole et al [22] and Hofmeyr et al [7] did not find any significant reduction in the risk of PPH when misoprostol was used as an add-on to routine uterotonics for the prevention of PPH (relative risk [RR] 0.96, 95% CI 0.63–1.45 and RR 0.64; 95% CI, 0.38–1.07 respectively). It is however not uncommon for the results of propensity score adjusted studies to differ from that of randomised controlled trials [23, 24].…”

Section: Discussionmentioning

confidence: 99%

Misoprostol as an adjunct to oxytocin can reduce postpartum-haemorrhage: a propensity score–matched retrospective chart review in Bamenda-Cameroon, 2015–2016

Morfaw

Fundoh

Pisoh

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background There is some evidence that suggests misoprostol may supplement the action of oxytocin in preventing post-partum haemorrhage (PPH). The primary objective of this study was to determine the effect of the administration of 600 μg misoprostol in addition to oxytocin versus oxytocin alone, on the risk of PPH among pregnant women after delivery. The secondary objectives were to determine the effects of the above combination on maternal death and blood transfusion among pregnant women after delivery; and to determine the incidence of PPH, its case fatality, and the maternal mortality ratio in our hospital. Methods Design and setting : Retrospective chart review of 1736 women delivering at the Regional Hospital Bamenda Cameroon, between 2015 and 2016. This was a pre versus post study following a policy change in the prevention of PPH. Exposure groups : One group received oxytocin-misoprostol (January–April 2016: period after policy change), and the second group received oxytocin-only (January–April 2015: period before policy change) after delivery. Outcomes : The primary outcome was PPH, and the secondary outcomes were maternal death and blood transfusion. Statistical analysis : A 1:1 matching with replacement was done with the propensity score (PS). The groups were compared using PS matching with conditional logistic regression on the matched pairs as the main analysis. A sensitivity analysis was done using other PS adjustment methods and multiple regression. Results Of the 1736 women included in this study, 1238 were matched and compared. Women who received oxytocin-misoprostol were less likely to have PPH as compared to those receiving oxytocin-only (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08, 0.59, p = 0.003). This reduced odds of PPH was upheld in the different sensitivity analyses. There were no significant differences in the odds of maternal death and the use of blood transfusions between the two groups: OR 3.91, 95% CI [0.44, 35.08], p = 0.22, and OR 0.89, 95% CI [0.14–5.63], p = 0.91, respectively. Sensitivity analyses showed similar results. The incidence of PPH was 2.9% (before adding misoprostol the incidence was 4.4% and after adding misoprostol it was 1.5%), the case fatality rate of PPH was 1.96%, and the overall maternal mortality ratio in the hospital was 293 maternal deaths/100000 life births. Conclusion Our evidence suggests that using 600 μg misoprostol as an add-on to oxytocin in the prevention of post-partum haemorrhage significantly reduces the odds of PPH without affecting other maternal outcomes.

show abstract

“…IJGO, because of its international focus, has recently been able to publish major randomized clinical trials that add to the evidence‐based literature on the gynecologic and obstetric use of misoprostol [7,8], the use of tranexamic acid to prevent and manage postpartum hemorrhage (PPH) [9], and innovative clinical approaches to the management of PPH [10]. In addition, we have published important papers describing clinical programs that can improve outcomes and health through the implementation of evidence‐based practices and interventions [11,12].…”

mentioning

confidence: 99%

IJGO at the FIGO 2012 Congress and beyond

Johnson

2012

Intl J Gynecology & Obste

View full text Add to dashboard Cite

A double‐blind, randomized, placebo‐controlled trial of misoprostol and routine uterotonics for the prevention of postpartum hemorrhage

Abstract: Misoprostol plus routine uterotonics resulted in modest reductions of blood loss in the third stage of labor, but the effects did not reach statistical significance. Larger studies are recommended.

Cited by 23 publications

References 27 publications

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

Misoprostol as an adjunct to oxytocin can reduce postpartum-haemorrhage: a propensity score–matched retrospective chart review in Bamenda-Cameroon, 2015–2016

IJGO at the FIGO 2012 Congress and beyond

Contact Info

Product

Resources

About